Tracheal intubation through the laryngeal mask airway using a gum elastic bougie: The effect of head position

Study Objective: To determine the effect of head position on success of tra cheal intubation through a Laryngeal Mask Airway (TM) (LMA) using a gum ela stic bougie. Design: Randomized, controlled study. Setting: Anesthesia and operating rooms of the University Hospital, Notting ham, UK. Patients: 20 patients scheduled to undergo routine elective surgery requiri ng the use of an LMA for anesthesia. Interventions: Blind placement of a gu m elastic bougie through an LMA in two head positions. Measurements and Main Results: Final position of the gum elastic bougie aft er removal of the LMA as determined by fiberoptic laryngoscopy. The gum ela stic bougie was correctly sited in the trachea in the classical intubating position in 4/20 (20%) and in the neutral position in 0/20 (0%). There was no difference in the success of this technique between the two head positio ns. Conclusions: This technique cannot be recommended as an alternative to dire ct laryngoscopy following a failed intubation. (C) 2001 by Elsevier Science Inc.