[Intubating laryngeal mask efficacy in obese and overweight patients].

Anesteziologiia i reanimatologiia

PubMedID: 24000654

Dolbneva EL, Stamov VI, Gavrilov SV, Mizikov VM. [Intubating laryngeal mask efficacy in obese and overweight patients]. Anesteziol Reanimatol. 2013;(2):58-63.
We evaluated the Intubating Laryngeal MAsk (ILMA Fastrach) efficacy for airway management, ventilation and blind intubation in obese and overweight patients. Methods. 50 adult patients (22 men and 28 women) with predicted difficult trachea intubation (PDTI), undergoing general anaesthesia with ILMA were included in this study. ILMA was selected according to gender: ILMA No 5 for men and No 4 for women. PREMEDICATION: diazepam and H,-blockers. Anaesthesia induction: midazolam 0. I - 0.15 mg/kg, propofol 1.6-2.5 mg/kg, fentanyl 0.1-0.15 microg/kg, rocuronii bromide or atracurii besilate 0.6 mg/kg.

21/2/3 patients had morbid obesity with BMI over 40/45/55 kg/m'. 5 and more difficult trachea intubation (TI) predictors were found in 48 patients. The ILMA was placed successfully at the first try for 7.2+/-2.9 sec in all patients. Ventilation was successful in 100% of cases; TI via ILMA - in 94% of cases (90% - at the first try). Total TI time was 7,5+/-4,8 sec, ILMA removal time - 9,2+1,5 sec. 2 patients had 2 or 3 DTI predictors, but conventional TI was unsuccessfild; TI via ILMA was performed at the first try. There was one "can't intubate, can't ventilate" case, TI via ILMA was made at the first try. TI via ILMA was unsuccessful in 3 patients, ILMA was replaced by Proseal LM or Supreme LM, TI was performed conventionally. There were no complications observed.

ILMA Fastrach was used successfiully in obese patients with PDTI for both ventilation and TI. Technique is simple in training, but a preliminary experience is essential for ILMA use in difficult cases.