Successful intubation in a difficult case using an Ambu Laryngeal Mask Angle Type-i, and the ability to pass a gastric tube behind the laryngeal mask
Tominaga, A.; Ueshima, H.; Ariyama, J.; Kitamura, A.
Masui. Japanese Journal of Anesthesiology 63(5): 545-547
2014
ISSN/ISBN: 0021-4892 PMID: 24864577 Document Number: 673031
A 71-year-old male was scheduled for a laparoscopic cholecystectomy. The plan was to intubate him using direct laryngoscopy. After induction of anesthesia and analgesia direct laryngoscopy was performed but it was difficult to get a good view of epiglottis, and at 2nd attempt there was laryngeal edema, which made the procedure more difficult. The patient was then ventilated with a facemask and it was decided to intubate him with an Ambu Laryngeal Mask Angle Type-i (Aura-i) and a bronchofiberscope. The procedure worked, and the patient was successfully intubated. We did not want to remove the Aura-i due to concerns about losing the airway. Therefore, we decided to place the gastric tube with the Aura-i still inserted. Therefore the cuff of the Aura-i was deflated and we were able to easily pass a gastric tube behind the Aura-i type easily. After the operation, the patient was extubated from the trachea with the Aura-i still in place. When sufficient respiration returned, the Aura-i was removed. There was no bleeding in the mouth after removal of the Aura-i.