INTUBATION USING LMA CTRACH IN ANAESTHETIZED BUT UNPARALYSED PATIENTS - A PILOT STUDY

BACKGROUND - Laryngeal Mask Airway (LMA) CTrach is a supraglottic device which is functionally identical to Intubating Laryngeal Mask airway (ILMA) which enables ventilation and allows real time visualization of endotracheal intubation. This study aimed at assessing the ease and efficacy of using LMA CTrach for orotracheal intubation in anaesthetized but unparalysed patients. MATERIAL AND METHODS : 40 patients of ASA Grade I/ II scheduled for elective surgeries requiring orotracheal intubation were studied. Anaesthesia was induced with fentanyl 1 µg.kg -1 and sevoflurane. Neuromuscular blockers were not used. After CTrach insertion, various corrective manoeuvres were used to obtain the best laryngeal view. Two ml of 2% lignocaine was instilled over the vocal cords via a small sized catheter and tracheal intubation was performed after 2 minutes. The haemodynamic parameters were recorded. Any complications occurring following the CTrach insertion or tracheal intubation and those in the post operative period were also recorded. RESULTS : The insertion of CTrach was easy and well tolerated in all the patients. Thirty percent of patients required corrective manoeuvres. Tracheal intubation was successful in all 40 patients in first or second attempt. The problems encountered were hypotension following tracheal intubation in 20% patients and bucking over the tube at the time of CTrach removal in 17.5% patients. Hypotension persisted only for 2-3 minutes. In the post operative period, mild sore throat and pain on swallowing were complained by four patients each, which resolved within 24 hours. CONCLUSION - The use of LMA CTrach to ventilate lungs and facilitate tracheal intubation in anaesthetized unparalysed patients appears to be a useful and safe technique as it does not