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LETTER TO EDITOR
Year : 2015  |  Volume : 59  |  Issue : 1  |  Page : 59-60  

Innovative way of making intubating laryngeal mask airway stabilizer rod


Department of Anesthesiology, Critical Care and Pain Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India

Date of Web Publication16-Jan-2015

Correspondence Address:
M Hanumantha Rao
Department of Anesthesiology, Critical Care and Pain Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati - 517 507, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.149463

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How to cite this article:
Rao M H, Muralidhar A, Subbarao A V, Vasudevan P M. Innovative way of making intubating laryngeal mask airway stabilizer rod. Indian J Anaesth 2015;59:59-60

How to cite this URL:
Rao M H, Muralidhar A, Subbarao A V, Vasudevan P M. Innovative way of making intubating laryngeal mask airway stabilizer rod. Indian J Anaesth [serial online] 2015 [cited 2020 Mar 29];59:59-60. Available from: http://www.ijaweb.org/text.asp?2015/59/1/59/149463

Sir,

Laryngeal mask airway (LMA) has become a standard device in the spectrum of gadgets for airway management. Intubating laryngeal mask airway (ILMA ® , LMA-fastrach ® ) is one of them. It was designed to overcome few difficulties of LMA-classic ® during tracheal intubation. [1],[2] After the trachea is intubated successfully through ILMA, it is usually recommended to remove the ILMA. [3],[4] The tracheal tube needs to be stabilized to prevent extubation during ILMA removal. A stabilizer rod (introducer, extender) is placed at the end of the tracheal tube and pushed inside while the ILMA is withdrawn. It is supplied along with the ILMA device. The initial price of ILMA is very high (Rs. 30,000 approximately). If it is used number of times, it becomes a cost effective choice. However, during repeated attempts of packing and sterilization, the stabilizer rod may get lost and rarely get damaged. If so, ILMA cannot be used for intubating purposes. Hence, we developed a stabilizer rod with some cheap disposable items available in the operating room. We successfully used this 'new' stabilizing rod in intubating the trachea.

We took a 6.5 mm internal diameter used red rubber noncuffed tracheal tube (Rusch, W. Germany), cut at 19 cm and then the bevel was also cut to make opening straight [Figure 1]a. A 16 French gauge nasogastric tube was also cut at the 20 cm length, and an old used disposable double lumen endobronchial tube stylet was introduced into the nasogastric tube [[Figure 1]b and c] to make the tube stiff. This unit was introduced into the prepared red rubber tracheal tube [Figure 1]d and the extra portion at the other end was cut [Figure 2]a and fixed with a rubber cap of antibiotic vial [Figure 2]b with adhesive glue. At the projected end, a cut suction catheter connector was inserted with glue ('Fevikwik'). A word of caution is to check the assembly before use for lose components. The extender made like this is comparable with that of the company make [Figure 2]c. This stabilizer (introducer, extender) can be as good as the original one [Figure 2]d. The cost of this is approximately less than Rs. 100 and can be reused number of times after autoclaving along with the ILMA.
Figure 1: (a) Used endobrocheal tube stylet, nasogastric tube cut at 20cm, 6.5 mm ID red rubber uncuffed tube cut at 19 cm and bevel straightend. (b) Endobronchial tube stylet is being introduced into nasgastric tube. (c) Stylet fully inserted into nasogastric tube. (d) Styleted nasogastric tube is introduced fully into red rubber tube

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Figure 2: (a) The extra portion of nasogastric tube is cut. (b) Fixation of the rubber cork with adhesive glue. (c) Comparison of stabilizer rod made [top] with original one. (d) Use of the stabilizer in successful intubation

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   References Top

1.
Brain AI, Verghese C, Addy EV, Kapila A, Brimacombe J. The intubating laryngeal mask. II: A preliminary clinical report of a new means of intubating the trachea. Br J Anaesth 1997;79:704-9.  Back to cited text no. 1
    
2.
Brinkschmidt TE, Kesei K, Hoch C. Controlled study of laryngeal mask versus tracheal tube for paediatric anaesthesia in strabismus surgery in 122 patients. Br J Anaesth 1997;78:101.  Back to cited text no. 2
    
3.
Brimacombe J, Keller C, Berry A. Pharyngolaryngeal morbidity with the intubating laryngeal mask airway. Anaesthesia 1998;53:1231.  Back to cited text no. 3
    
4.
Brimacombe J, Keller C. Pharyngeal mucosal pressures. In reply. Anesthesiology 2000;92:621.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2]



 

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