INTUBATION VIA THE LMA USING A COOK RETROGRADE INTUBATION KIT

Purpose: We report two cases of difficult intubation where a laryngeal mask airway (LMA) was used and changed to a conventional endotracheal tube using a retrograde intubation set. Clinical findings: In two pat ients, following induction of anaesthesia, the trachea could not be in tubated in the conventional fashion with a blade. In both patients an LMA was inserted to achieve an airway. In both patients intubation wit h a conventional endotracheal tube was required. A Cook Retrograde Int ubation Kit and fibreoptic bronchoscope were used to change the LMA to conventional endotracheal tube without problems, Conclusion: The Cook retrograde intubation allows an LMA to be replaced with an endotrache al tube with an ID greater than 6 mm with a #3 or 7 mm with a #5 LMA. This technique places an exchange stylet into the airway which is supe rior to a conventional guidewire. This method allows the airway to be maintained until the LMA is exchanged with an endotracheal tube. Anaes thesia may be maintained and the airway instrumented without difficult y using this technique.