Awake intubation using the LMA‐CTrach^™ in patients with difficult airways*

Abstract

SummaryWe studied 21 patients with known difficult airways who underwent awake tracheal intubation using the LMA CTrach TM . Patients were given midazolam, atropine, a continuous infusion of remifentanil and topical lidocaine applied to the oropharyx. We limited the number of insertion attempts to three and the time to adjust the view to 5 min. In case of failure, we performed awake fibreoptic tracheal intubation. We found insertion of the device was successful and well tolerated in all patients. Vocal cords could be seen immediately in nine patients and following corrective manoeuvres in 10 patients. Tracheal intubation was successful in 20 patients: 19 cases under direct vision and in one blindly. In one patient with undiagnosed lingual tonsil hyperplasia, tracheal intubation was impossible using the device. No patient had an unpleasant recall of the procedure. We conclude that the LMA CTrach is easy to use, well tolerated and suitable for awake orotracheal intubation in patients with known difficult airways.

Intubation Using Lma Ctrach in Anaesthetized but Unparalysed Patients – A Pilot Study

“…However, awake intubation using CTrach requires patient's cooperation and has the potential risk of recall and patient discomfort. Lopez et al reported the use of the LMA CTrach for awake intubation in 21 patients with difficult airway using sedation and topical instillation of lignocaine to anaesthetize the larynx 8 . They found CTrach easy to use for awake orotracheal intubation.…”

“…Thus LMA CTrach can be a useful airway adjunct for management of difficult airway situation. It has been used for tracheal intubation after administration of neuromuscular blocking agents; awake insertion of the device followed by intubation using high concentrations of sevoflurane; or awake intubation using topical anaesthesia 1,2,4,6,8 . All these methods have their own limitations.…”

The LMA CTrach™ in morbidly obese and lean patients undergoing gynecological procedures: a comparative study

“…It has been successfully used to manage both potential [11][12][13] and unanticipated [8] difficult airways in anesthetized patients.…”

Modification in Laryngeal mask airway CTrach tube design

“…The LMA C Trach ET intubation tube has a black horizontal line 10 cm proximal to the cuff and as this line starts disappearing from the barrel of the LMA C Trach the epiglottis elevating bar gets lifted and the tracheal intubation is facilitated under direct vision. [4] Following ET intubation tube, LMA C Trach is removed.…”