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Electronic Letters to:

Clinical Investigation:
R. Komatsu, O. Nagata, K. Kamata, K. Yamagata, D. I. Sessler, and M. Ozaki
Intubating laryngeal mask airway allows tracheal intubation when the cervical spine is immobilized by a rigid collar
Br. J. Anaesth. 2004; 0: aeh248v1 [Abstract] [PDF]
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[Read E-letter] Use of the intubating laryngeal mask airway in the presence of a rigid cervical collar
Anita Jhamatt   (9 February 2005)

Use of the intubating laryngeal mask airway in the presence of a rigid cervical collar 9 February 2005
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Anita Jhamatt,
SHO Anaesthesia, Liverpool, U.K.

Send letter to journal:
Re: Use of the intubating laryngeal mask airway in the presence of a rigid cervical collar

Dear Editor

I read with interest the article by Komatsu et al [1]. Several points maybe relevant before extrapolation of their findings to U.K. practice.

The intubating LMA is not routinely available in all U.K. hospitals. The success of the authors was, no doubt, due to the vast experience of the single anaesthetist involved in the study. Successful intubating LMA insertion-intubations appears, therefore, to be experience dependent. This emphasises the importance of practical teaching on the use of the intubating LMA, both in the presence and absence, of a rigid cervical collar.

The Philadelphia collar is infrequently used within the U.K. It would be interesting to investigate the use of the intubating LMA in patients who are immobilised with a rigid cervical collar commonly used within the U.K. (e.g. Aspen collar).

Population parameters presented by Komatsu et al. largely differ from those of the population served by most U.K. hospitals e.g. mean weight. The findings cannot, therefore, be directly applied to the typical U.K. population.

[1] Komatsu R, Nagata O, Kamata K et al. Intubating laryngeal mask airway allows tracheal intubation when the cervical spine is immobilised by a rigid collar. British Journal of Anaesthesia 2004; 93 (5): 655-9.

Conflict of Interest:

None declared