Impact du grade de Cormack et Lehane sur l'utilisation du masque laryngé Fastrach™ : étude en chirurgie gynécologique

Abstract

Objective. – To evaluate the impact of Cormack and Lehane grade on the Intubating Laryngeal Mask Airway (LMA-Fastrach ™) using in women. Study design. – Open prospective study. Patients. – The study included 115 scheduled gynaecologic surgery women. Methods. – An LMA-Fastrach ™ was systematically performed in patients with a Cormack's grade ≥ 3 or when Arné's score was ≥ 7 whatever the Cormack. After induction of anaesthesia and neuromuscular blockade, Cormack's grade was assessed and LMA-Fastrach ™ was inserted. Proper insertion was confirmed by the easiness of assisted ventilation and the normal aspect of the capnographic curve. Intubation through the LMA-Fastrach ™ was carried out with the specific kit's endotracheal tube. More than two attempts were considered as a failure of the technique and an alternative method was performed. The following parameters were noted: age, weight, height, clinical predictors for difficult intubation (Arne et al.'s score), number of LMA-Fastrach ™ insertion, ventilation efficiency through LMA-Fastrach ™, successful intubation with LMA-Fastrach ™ and oesophageal intubation. Results. – Ventilation through the LMA-Fastrach ™ was efficient in 97%. The success rate of intubation was 94.8% (86% on the first attempt). The success rate of ventilation and intubation were not statistically different according to the different Cormack's grades. The obesity (BMI > 30) did not change the success rate of ventilation and intubation through the LMA-Fastrach ™. Conclusion. – In women with either predicted or unpredicted difficult intubation, the success rates of ventilation and intubation through the LMA-Fastrach ™ don't seem to be influenced by Cormack grade and obesity.