Intubation through the laryngeal mask. A technique for unexpected difficult intubation.

Unexpected difficulty with tracheal intubation contributes to anaesthetic mortality. The laryngeal mask can almost always be placed satisfactorily and its position should facilitate blind intubation. A 6-mm cuffed tube will pass through both adult sizes of the mask and this study tested the feasibility of intubation through the mask. The effect of the application of cricoid pressure on the technique was also investigated. Intubation via the laryngeal mask was attempted in 100 routine patients: of the first 50 (group 1, no cricoid pressure), 45 (90%) were successfully intubated. Maintenance of cricoid pressure throughout the manoeuvre (group 2) reduced the success rate significantly to 56% (p less than 0.05). Despite the possibility that cricoid pressure may have to be interrupted momentarily, the ease with which the technique can be learnt, and the immediate availability of the necessary apparatus suggest that it should be considered for inclusion in failed intubation drill.