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Yvon F. Bryan,T. Wesley Templeton 대한마취통증의학회 2016 Korean Journal of Anesthesiology Vol.69 No.4
The laryngeal mask airway (LMA) ClassicTM 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 ClassicTM 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’sTM 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.