Air-Q intubating laryngeal airway: A study of the second generation supraglottic airway device

Abstract

Background and Aims:Air-Q intubating laryngeal mask airway (ILA) is used as a supraglottic airway device and as a conduit for endotracheal intubation. This study aims to assess the efficacy of the Air-Q ILA regarding ease of insertion, adequacy of ventilation, rate of successful intubation, haemodynamic response and airway morbidity.Methods:Sixty patients presenting for elective surgery at our Medical College Hospital were selected. Following adequate premedication, baseline vital parameters, pulse rate and blood pressure were recorded. Air-Q size 3.5 for patients 50-70 kg and size 4.5 for 70-100 kg was selected. After achieving adequate intubating conditions, Air-Q ILA was introduced. Confirming adequate ventilation, appropriate sized endotracheal tube was advanced through the Air-Q blindly to intubate the trachea. Placement of the endotracheal tube in trachea was confirmed.Results:Air-Q ILA was successfully inserted in 88.3% of patients in first attempt and 11.7% patients in second attempt. Ventilation was adequate in 100% of patients. Intubation was successful in 76.7% of patients with Air-Q ILA. 23.3% of patients were intubated by direct laryngoscopy following failure with two attempts using Air-Q ILA. Post-intubation the change in heart rate was statistically significant (P < 0.0001). 10% of patients were noted to have a sore throat and 5% of patients had mild airway trauma.Conclusion:Air-Q ILA is a reliable device as a supraglottic airway ensuring adequate ventilation as well as a conduit for endotracheal intubation. It benefits the patient by avoiding the stress of direct laryngoscopy and is also superior alternative device for use in a difficult airway.

Comparison of Ambu® AuraGain™ laryngeal mask and air-Q™ intubating laryngeal airway for blind tracheal intubation in adults: A randomized controlled trial

“…Malhotra et al reported intubation success rate at first attempt with air-Q TM is around 69% and an overall success rate of over 96% [1]. However, reported mean intubation time with air-Q TM was 15 s while we have found a median intubation time of 22 s. A recent observational study by Attarde et al found that blind intubation success rate at first attempt through air-Q TM is 56.7% and overall success rate is 76.7% [8]. No previous study reported blind intubation success rate through Ambu Ò AuraGain TM .…”

Blind Intubation through Self-pressurized, Disposable Supraglottic Airway Laryngeal Intubation Masks

“…Previous smaller studies reported that ventilation through this supraglottic airway device was adequate in 88 to 100% of patients. [4][5][6]12,13 However, we found that insertion of the supraglottic airway and subsequent adequate ventilation and oxygenation was successful in 994 of 1,000 patients, representing a convincing success rate of 99%. Insertion of the supraglottic airway required just 21 s, which confirms previous findings reporting insertion times between 15 and 27 s. 6,17 Furthermore, insertion was rated as easy or very easy in 87% of the patients.…”

“…First-attempt blind intubation success through the supraglottic airway was 69% in our study, confirming previous findings reporting first-pass blind intubation success rates ranging between 57 and 70%. 6,12,17,18 With a maximum of…”

“…two attempts, our overall success rate was 78%, which was well within the wide 24 to 97% range reported previously. [4][5][6]12,13,17 It seems likely that the wide range reported previously reflects methodologic differences, including the fact that some studies allowed up to three blind intubation attempts or were restricted to specific patient populations. And although hard to quantify, operator skill levels surely contributed to varying success rates.…”

“…[9][10][11] However, only a few small studies assess the suitability of the supraglottic airway as a conduit for blind intubation in adults. [4][5][6]12,13 Our goal was thus to evaluate the feasibility and clinical performance of the supraglottic airway in a large, multicenter cohort of surgical patients.…”