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

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.