Korean J Anesthesiol.  2016 Aug;69(4):390-394. 10.4097/kjae.2016.69.4.390.

A two-stage approach to induction and intubation of two infants with Pierre Robin Sequence using a LMA Classic™ and Air-Q®: two cases report

• Templeton
• Bryan YF

• KMID: 2344607
• DOI: http://doi.org/10.4097/kjae.2016.69.4.390

Abstract

The laryngeal mask airway (LMA) Classicâ„¢ and Air-Q® are supralaryngeal devices used for airway management in routine and difficult pediatric airways. We describe a novel two-stage technique of insertion of the LMA Classicâ„¢ awake prior to induction of anesthesia, to assure oxygenation and ventilation, and after induction removal and placement of the Air-Q® for intubation using the flexible fiberoptic bronchoscope. The LMA Classic'sâ„¢ pliable design and relatively small size allow it to be easily placed in awake infants. In contrast, the Air-Q® is an excellent device for intubation because of its larger internal diameter and removable 9 mm adapter. Our goal was to reduce unpredictability and potentially increase the safety of induction of anesthesia and intubation in infants with Pierre Robin sequence. By using these devices in a two-stage approach we created a technique for consistent oxygenation, ventilation, and intubation in these infants.

Keyword

Airway management; Induction; Intubation; Pierre robin sequence

MeSH Terms

Airway Management
Anesthesia
Bronchoscopes
Humans
Infant*
Intubation*
Laryngeal Masks
Oxygen
Pierre Robin Syndrome*
Ventilation
Oxygen