• Hideyuki Miyazaki, Takashi Asai, Tomoko Kambara, Atsushi Nagata, and Koh Shingu.
• Department of Emergency and Critical Care, Kansai Medical University, Moriguchi 570-8506.
• Masui. 2009 Feb 1;58(2):193-4.

AbstractA 59-year-old man with cervical spondylosis was scheduled for a posterior spine surgery. After induction of anaesthesia with propofol and fentanyl, and neuromuscular blockade with vecuronium, the trachea was intubated using an 8.0-mm ID refinforced tube, without difficulty. After inflation of the cuff with 6 ml of air, there was no gas leak around the tube. The patient was placed in the prone position, and the head fixed to the operating table, using head pins. Several minutes later, there was a marked gas leak around the tracheal tube cuff. Addition of air to the cuff did not solve the problem, indicating rupture of the cuff. A size 5 laryngeal mask airway was inserted while the tracheal tube was left in place with the patient in the prone position. Inflation of the cuff of the laryngeal mask with 15 ml of air and occluding the connector part of the laryngeal mask prevented the gas leak, and adequate ventilation volume could be maintained afterwards. We believe that insertion of the laryngeal mask airway may be useful in minimizing gas leakage around a tracheal tube.

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