The intubating laryngeal mask airway (ILMA): initial experience in Singapore

We have evaluated the intubating laryngeal mask airway (ILMA) for ventilation and for blind tracheal intubation. After induction of anaesthesia with fentanyl 1 microgram kg-1 and propofol 3 ml kg-1, the ILMA was placed successfully on the first attempt in all 100 patients. After administration of atracurium 0.5 mg kg-1, blind tracheal intubation was successful in 97% of patients--50% on the first attempt, 42% on the second and 5% on the third. Success was improved by pulling the metal handle of the ILMA towards the intubator in an "extension" manoeuvre, if intubation was not possible on the first attempt. These findings confirm the effectiveness of the ILMA in an Asian population.