As indirect laryngoscopic tools become more available, and clinicians become more facile in their use, the management of (potentially) difficult intubations is likely to change. Further technological advances are likely to lead to the development of even more new instruments.

SummaryThe intubating laryngeal mask airway is a new device that facilitates intubation of the trachea. We assessed its use in 15 awake patients in whom we anticipated difficulty with tracheal intubation; we would otherwise have secured the patients' airways using a fibreoptic bronchoscope. All patients were sedated and had their airways anaesthetised with local anaesthetic. The tracheas of all 15 patients were successfully intubated. The mean time from start of sedation to successful intubation was 10.8 min. The mean time from completion of sedation and airway local anaesthesia to tracheal intubation was 2.8 min. Patients remained haemodynamically stable throughout, peripheral oxygen saturation was maintained and there were no obvious cases of pulmonary aspiration. Most patients complained of sore throat and hoarseness. We have demonstrated through this descriptive study that the intubating laryngeal mask airway may, in certain circumstances, be used as an alternative to the fibreoptic bronchoscope.

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Summary The Gastro‐Laryngeal Tube is a modification of the Laryngeal Tube that provides a dedicated channel for the insertion of a gastroscope. In this study of 30 patients undergoing general anaesthesia for endoscopic retrograde cholangiopancreatography, we evaluated both the effectiveness of airway management with a Gastro Laryngeal Tube and the feasibility of performing it using the endoscopic channel. The Gastro Laryngeal Tube was inserted successfully in all patients, in 27 patients at the first attempt. The mean (SD) time to achieve an effective airway was 26 (6) s. Mean (SD) inspiratory and expiratory tidal volumes were 336 (57) ml and 312 (72) ml, respectively, and oropharyngeal leak pressure was 33.7 (2) cmH2O. These data suggest that the Gastro Laryngeal Tube is an effective and secure device for airway management and for use during performance of endoscopic retrograde cholangiopancreatography.