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Intubating Laryngeal Mask Airway in Lateral Position

Dimitriou, V MD, DEAA; Iatrou, C MD; Brimacombe, J MD, MB, ChB, FRCA; Voyagis, G S. MD

doi: 10.1213/01.ANE.0000139730.16931.8D
Letters to the Editor: Letters & Announcements
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Department of Anaesthesia; University of Thrace; Alexandroupolis, Greece (Dimitriou, Iatrou)

Department of Anaesthesia and Intensive Care; University of Queensland and James Cook University; Cairns Base Hospital; Cairns, Australia; jbrimaco@bigpond.net.au (Brimacombe)

Department of Anaesthesia; Sotiria Hospital; Athens, Greece (Voyagis)

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To the Editor:

We read with interest the recent study by Komatsu et al. (1) concerning the use of the intubating laryngeal mask airway (ILMA) for blind tracheal intubation in the right and left lateral and supine positions. In their discussion, the authors correctly state that in a similar study (published as an abstract in 2000) (2) using flexible lightwand-guided intubation through the intubating LMA, our group investigated only the right lateral and supine positions and provided no information about the frequency of esophageal intubation; however, the authors incorrectly state that we provided no information about the frequency of adjusting maneuvers, which was similar to their study. Most importantly, in a follow-up study (published as a full paper in 2003) (3), we investigated both the right and left lateral and supine positions, and provided information about both the frequency of adjusting maneuvers and esophageal intubation. We found that the ILMA was successfully inserted in all patients at the first attempt and flexible lightwand-guided intubation was successful in all patients, with an average of 1.09 attempts and 0.58 adjusting maneuvers. The frequency of esophageal intubation was 6%. There were no differences in the time taken, the number of insertion attempts, the number of adjusting maneuvers, or the number of accidental esophageal intubations between the right and left lateral and supine positions. These findings support those of Komatsu et al. (1).

V. Dimitriou, MD, DEAA

C. Iatrou, MD

Department of Anaesthesia

University of Thrace

Alexandroupolis, Greece

J. Brimacombe, MD, MB, ChB, FRCA

Department of Anaesthesia and Intensive Care

University of Queensland and James Cook University

Cairns Base Hospital

Cairns, Australia

jbrimaco@bigpond.net.au

G. S. Voyagis, MD

Department of Anaesthesia

Sotiria Hospital

Athens, Greece

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References

1. Komatsu R, Nagata O, Sessler DI, Ozaki M. The intubating laryngeal mask airway facilitates tracheal intubation in the lateral position. Anesth Analg 2004;98:858–61.
2. Dimitriou V, Voyagis GS. Light-guided tracheal intubation in the lateral position through the intubating laryngeal mask [abstract]. Eur J Anaesthesiol 2000;(Suppl 19):A90.
3. Dimitriou V, Voyagis GS, Iatrou C, Brimacombe J. Flexible lightwand-guided intubation using the intubating laryngeal mask airway in the supine, right, and left lateral positions in healthy patients by experienced users. Anesth Analg 2003;96:896–8.
© 2004 International Anesthesia Research Society