Manikin study of fibreoptic‐guided intubation through the classic laryngeal mask airway with the Aintree intubating catheter vs the intubating laryngeal mask airway in the simulated difficult airway*

Abstract

In this randomised crossover manikin study of simulated difficult intubation, 26 anaesthetists attempted to intubate the trachea using two fibreoptic-guided techniques: via a classic laryngeal mask airway using an Aintree intubating catheter and via an intubating laryngeal mask airway using its tracheal tube. Successful intubation was the primary endpoint, which was completed successfully in all 26 cases using the former technique, and in 5 of 26 cases using the latter (p < 0.0001). The former technique also proved quicker to reach the vocal cords with the fibrescope (median (IQR . We conclude that in simulated difficult intubation, fibreoptic intubation appears easier to achieve using a classic laryngeal mask airway and an Aintree intubating catheter than through an intubating laryngeal mask airway.

Laryngeal Mask, Laryngeal Tube, and Frova Introducer in Simulated Difficult Airway

“…We found only a few references using introducers through an SGD to facilitate tracheal intubation for difficult airway management, but always guided by fiberoptic bronchoscope (13,14).…”

The LMA Classic™ as a conduit for tracheal intubation in adult patients: a review and practical guide

“…The LMA Classic ™ /Aintree ® Intubation Catheter/fibre-optic technique had a higher success rate (26/26 vs. 5/26) and took a shorter time (18 vs. 110 seconds) to successful tracheal intubation, than an LMA Fastrach ™ /Fastrach endotracheal tube/fibre-optic technique in a randomised crossover simulated difficult airway study. 49 No significant difference was found when comparing the LMA Classic ™ and the LMA ProSeal ™ with regard to ease of advancement or view of the vocal cords with an Aintree ® Intubation Catheter-mounted fibrescope in the second manikin study. 50 Twenty-five anaesthetists of all grades performed the intubations.…”

S1 guidelines on airway management

“…If the blind endotracheal intubation fails or if a different EGA is primarily chosen, a flexible intubation endoscope can be used for endotracheal guidance; alternatively an intubation catheter can be initially placed serving as a tracheal guide splint for secondary tube advancement [34][35][36].…”