Insertion of the Combitube airway with the cervical spine immobilised in a rigid cervical collar

The Combitube is a twin lumen device designed to establish the airway after blind insertion. Under general anaesthesia a rigid cervical collar was used to immobilise the neck in 15 ASA 1 and 2 patients. Insertion of the Combitube airway was then attempted. In 10/15 (66%) patients, blind insertion was not possible. In 5/15 (33%) successful blind insertions the Combitube entered the oesophagus on each occasion. In 8/10 of the failures, re-insertion of the Combitube was attempted with the aid of a Macintosh laryngoscope. In 6/8 cases (75%) satisfactory placement was then possible with the Combitube again entering the oesophagus on each occasion. Ventilation was satisfactory in all patients when insertion was successful. Blood staining of the Combitube was present in 7/15 (47%) patients. The Combitube cannot be recommended for use in patients whose necks are immobilised in rigid cervical collars.