Modification of the LMA-Unique to facilitate endotracheal intubation.

摘要

Airway management can present challenges during conscious sedation for specialized cases performed under regional or local anesthesia such as awake craniotomy. When progressive sedation levels are required, initially the airway can be managed with the laryngeal mask airway (LMA; LMA North America, San Diego, CA, USA) or the single-use LMA-Unique (LMA-U).If airway protection is needed or positive pressure ventilation is required, conversion to an endotracheal tube (ETT) may then be warranted. Blind passage of a standard ETT through the LMAU is rarely successful, with less than 25% success in one series but fibreoptic guidance may provide visualization for intubation. We have modified an LMA-U and ETT to successfully secure the airway.