Use of the Aintree intubation catheter® in a patient with an unexpected difficult airway

Abstract

Purpose: To present a case where the Aintree intubation catheter® (AIC) was used in conjunction with the Laryngeal Mask Airway® (LMA) and a fibreoptic bronchoscope (FOB) in a patient with an unexpected difficult airway. Clinical features: A 38-yr-old 90 kg man scheduled for nasal endoscopy with ethmoidectomy under general anesthesia was found, unexpectedly, to be difficult to intubate using both a Macintosh laryngoscope (#4 blade) and a GlideScope® video laryngoscope despite having an airway examination that was unremarkable except for slightly decreased mouth opening and a large tongue. Intubation was achieved by inserting a size 5 disposable LMA into the upper airway, introducing a FOB into an AIC inserting the FOB/AIC assembly into the trachea via the LMA, removing the LMA, and then passing a regular size (7.5 mm) endotracheal tube into the trachea over the AIC. Conclusion: In this patient, the AIC provided an effective alternative to other methods for intubating through a regular LMA.