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The Proseal^TM LMA is a useful rescue device during failed rapid sequence intubation: two additional cases

[Le ML Proseal^TM est un instrument de secours utile pour l’intubation pendant une induction à séquence rapide : deux nouveaux cas]

From the Department of Anaesthesia, Royal United Hospital, Combe Park, Bath, United Kingdom.

Address correspondence to: Dr. T. M. Cook, Dept of Anaesthesia, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK. Phone: +44 1225 825056; Fax: +44 1225 825061; E-mail: timcook{at}ukgateway.net

Purpose: We report two cases where the ProSeal^TM laryngeal mask airway (PLMA) was successfully used as a rescue device, after failed tracheal intubation, during rapid sequence induction.

Clinical findings: The first case involved a 31-yr-old primigravida presenting for emergency Cesarean section for severe fetal distress. She had a grade 3 larynx and airway edema was observed during laryngoscopy. Attempts with a McCoy blade and gum elastic bougie failed to secure the airway. A size 4 PLMA was inserted with good airway control and surgery proceeded uneventfully. The second case involved a 51-yr-old man presenting for appendectomy. Following failed attempts at intubation, a size 5 PLMA was succesful in securing his airway and surgery proceeded uneventfully.

Conclusions: The correctly placed PLMA has potential advantages over the cLMA for airway rescue in the circumstance of failed emergency intubation in a patient with a potentially full stomach. In the two cases reported, the PLMA provided effective rescue of the airway.

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