Use of the Laryngeum Mask for Intubation (Fastrach): Initial Experience in the Specialty Hospital “Dr. Bernardo Sepulveda G”, Centro Medico Nacional Siglo XXI IMSS Mexico

Abstract

There is unanimous agreement that if planning is done for the management of the airway, the vast majority of complications can be prevented or solved. The American Society of Anesthesiology in recent years has developed an algorithm to follow in case of presenting a difficult and unexpected airway. In this algorithm, various techniques or mechanisms other than direct laryngoscopy are mentioned, which may at a certain moment resolve a pressing situation. The laryngeal mask for intubation (Fastrach) is a device that has increased its popularity by playing an important role in the management of the anatomically difficult airway allowing adequate oxygenation. It offers advantages such as simplicity and versatility in its placement, as well as being a traumatic for the patient. We decided to carry out this project to obtain an initial experience in the management of the airway with this type of devices whose successful results in other countries have not been corroborated in our hospital. Objective: To demonstrate that the laryngeal mask for intubation (Fastrach) is a useful device for the management of the airway in patients undergoing general anesthesia. Material and method: We studied 50 patients of both genders and ages between 22 and 85 years, physical status ASA I, II or III, scheduled for elective surgery and general anesthetic technique. The number of attempts of Fastrach placement and orotracheal intubation through it, the time in seconds, the hemodynamic and SpO2 values, and finally the complications during and after the procedure (oral bleeding, impossibility to place Fastrach and/or IOT, odynophagia and/or dysphonia). Results: A success rate was obtained for the placement of Fastrach and I.O.T. 94% where 54% was the first attempt, 32% the second and 4% the third attempt. The complications presented were minimal and reached 2%. Conclusion: The use of the laryngeal mask for intubation (Fastrach) as an alternative to direct laryngoscopy for orotracheal intubation in patients with easy airway is feasible and has been shown to be useful, safe and effective.