The failure rate of
blind intubation is high, and above all,
blind intubation may cause tissue damage.
The LMA FastrachTM is such a supraglottic device to provide the patient ventilation as well as for securing definitive airway via
blind intubation. However, it is criticized as
blind intubation through it has the potential for causing arytenoid trauma or oesophageal placement.
While the first patient was intubated on second attempt with
blind intubation technique the latter was intubated on the third attempt without usage of any alternative device.
There has however, been a case report of a fatal oesophageal rupture with
blind intubation through an intubating laryngeal mask (18).
For the severely retrognathic infant or child, airway management frequently involves
blind intubation or tracheostomy under local anesthesia.
Blind intubation via the ILMA: What about accidental oesophageal intubation?
They also include
blind intubation (oral or nasal) and fibreoptic intubation in their list of techniques for difficult airway management.
Joo and Rose(6) reported that the haemodynamic response to blind and fibreoptic-guided intubation with the ILMA was less than the response to conventional laryngoscope-guided tracheal intubation whereas Kihara et al(7) observed that
blind intubation through an ILMA had no advantage over laryngoscope-guided tracheal intubation in patients with normal airways.
After three failed attempts, or if the best quality of laryngeal view remained poor, one
blind intubation attempt was allowed in the CTrach[TM] group.