A comparison of fibreoptic‐guided tracheal intubation through the Ambu^®Aura‐i^™, the intubating laryngeal mask airway and the i‐gel^™: a manikin study

Abstract

SummaryWe compared the Aura-i TM , intubating laryngeal mask airway and i-gel TM as conduits for fibreoptic-guided tracheal intubation in a manikin. Thirty anaesthetists each performed two tracheal intubations through each device, a total of 180 intubations. (22-35 [14-59]) s for the Aura-i, intubating laryngeal mask airway and i-gel, respectively. Tracheal intubation through the i-gel was the quickest (p < 0.01). Resistance to railroading of the tracheal tube over the fibrescope was significantly greater through the Aura-i compared with the intubating laryngeal mask airway and the i-gel (p = 0.001). There were no failures to intubate through the intubating laryngeal mask airway or the i-gel but six intubation attempts through the Aura-i were unsuccessful, in five owing to a railroading failure and in one owing to accidental oesophageal intubation. We conclude that the Aura-i does not perform as well as the intubating laryngeal mask airway or the i-gel as an adjunct for performing fibreoptic-guided tracheal intubation.

A cohort evaluation of clinical use and performance characteristics of Ambu® AuraGain™: A prospective observational study

“…The authors have reasoned that Aura-i has a flat angle of exit, which may result in the fibrescope or tracheal tube exiting more posteriorly and heading towards the oesophagus. [ 21 ] Furthermore, all patients who required two attempts at intubation had an initial Brimacombe grade of ≤2.…”

Comparative evaluation of Ambu Aura-i and Fastrach™ intubating laryngeal mask airway for tracheal intubation: A randomized controlled trial

“…Recently, de Lloyd et al [ 25 ] compared the three intubating SAD, Aura-i, FT-LMA, and i-gel as conduits for fiberoptic-guided tracheal intubation in a randomized and crossover manner in a manikin study and concluded that the Aura-i does not perform well as compared with FT-LMA or the i-gel as an adjunct for performing fiberoptic-guided tracheal intubation. They explained the lower success rate with Aura-i because of the flatter angle of exit at distal portion, which may result in the tracheal tube leaving fiberscope more posteriorly and directing towards the esophagus, as compared with FT-LMA and i-gel, which have an elevated exit course.…”

Comparison of learning performance of 2 intubating laryngeal mask airways in novice

“…It is appropriate to perform endotracheal intubation through intubating LMAs utilizing fibrobrochoscope after recovery of spontaneous circulation. [27] de Lloyd et al [28] compared Aura-i and i-gel for fibreoptic-guided tracheal intubation in a manikin and showed quicker endotracheal intubation through i-gel and more failures through the Aura-i. Second, it was a manikin-based study that may not be definitively extrapolated to clinical application.…”