Dimitriou, Vasilios, Voyagis, Gregory S., Iatrou, Christos, and Brimacombe, Joseph R. (2003) Flexible lightwand-guided intubation using the intubating laryngeal mask airway ™ in the supine, right, and left lateral positions in healthy patients by experienced users. Anesthesia and Analgesia, 96 (3). pp. 896-898.

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Abstract

Tracheal intubation is usually performed with the patient in the supine position; however, it is occasionally required in the lateral position if there is loss of airway control during surgery in the lateral position, if patients cannot be moved from the lateral position because of pain, if patients are trapped in the lateral position, or perhaps to reduce the risk of aspiration at the induction in the presence of oropharyngeal bleeding. Laryngoscope-guided tracheal intubation is more difficult in the lateral than the supine position because airway anatomy is distorted, and the practitioner is in an unfamiliar posture (1), but there is prospective evidence that the classic laryngeal mask airway is easy to insert in the lateral position in patients with normal airways (2) and anecdotal evidence that it is easy to insert in emergency situations where other airway devices have failed (3,4). Our group described two cases where the intubating laryngeal mask airway™ (ILMA; Laryngeal Mask Company, Henley-on-Thames, United Kingdom) was successfully used as a rescue ventilatory device and aid to lightwand-guided intubation in two patients in the lateral position (5). In the following study, we compare flexible lightwand-guided intubation using the ILMA in the supine, right, and left lateral positions by experienced users.

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