Lingual tonsillar hypertrophy: Cause of un-anticipated difficult intubation

590 Journal of Anaesthesiology Clinical Pharmacology | October-December 2014 | Vol 30 | Issue 4 Air-Q ILA blocker was not performed as the surgery was of short duration, and there was no evidence of pulmonary aspiration. S J Twigg and Cook[4] reported successful use of Proseal LMATM (Laryngeal Mask Airway Company Ltd, UK) in a patient of RTS. However, intubation through the ProSeal LMA may be difficult and cumbersome due to narrower airway tube. Successful endotracheal intubation using Air-Q ILA in patients with anticipated difficult airway[5] and a child with RTS[6] could be found in the literature. We chose Air-Q ILA blocker (Cookgas LLC, Mercury Medical, Clearwater, FL, USA) as it combines the advantages of a conduit for subsequent intubation (as its shape is like intubating LMA and unlike ProSeal LMA) and providing secured airway with nearly complete protection against gastric aspiration, due to the presence of a separate gastric drainage channel with in-built esophageal blocker. Air-Q blocker is available in three sizes of 2.5, 3.5, and 4.5 for patients weighing between 30-50 kg, 50-70 kg, and 70-100 kg respectively. The device has integrated bite block. We found it easy to insert, cuff leak was minimal, and ventilation was effective. The insertion of esophageal blocker was also easy. There was no cough and sore throat in the postoperative period.