Awake tracheal intubation via intubating laryngeal mask vs direct laryngoscopy and cervical spine excursion

Abstract

Objective: To compare intubating laryngeal mask airway (ILMA) with direct laryngoscopy in patients with cervical spine injury. Patients and Methods: Prospective, hospital based study conducted during March 2004 to May 2005, in Imam Khomeini Hospital, Tabriz Medical Science University, Iran. We compared the excursion of the upper cervical spine during tracheal intubation using direct laryngoscopy with awake intubation via Laryngeal mask airway in 40 patients. Results: Intubating laryngeal mask caused less extension (at C2-3 and C1-2) than intubation by direct laryngoscope. Patients, who were locally anesthetized and sedated tolerate intubation well. However laryngoscopy is still the fastest method to secure an airway. Conclusion: In traumatic patients who require intubation and have limitation with cervical spine movement, we can use intubating laryngeal mask in awake patients locally anesthetized as a safe, tolerable and relatively fast method to secure an airway.