The air-Q as a conduit for fiberoptic aided tracheal intubation in adult patients undergoing cervical spine fixation: A prospective randomized study

Samir, Enas M.; Sakr, Sameh

doi:10.1016/j.egja.2011.12.002

Cited by 12 publications

(11 citation statements)

References 12 publications

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“…We found no significant difference in time to fibreoptic‐guided tracheal intubation between the two groups. These findings compare favourably with studies looking at fibreoptic‐guided tracheal intubation via other SADs (including the i‐gel) .…”

Section: Discussionsupporting

confidence: 70%

Fibreoptic‐guided tracheal intubation through i‐gel^® and LMA^® Protector^TM supraglottic airway devices ‐ a randomised comparison

Mendonca¹,

Tourville²,

Jefferson

et al. 2018

Anaesthesia

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Fibreoptic-guided tracheal intubation using a supraglottic airway device as a conduit is a technique that can be used in anticipated and unanticipated difficult airway management. Although the i-gel â supraglottic airway device has been examined for this purpose, the LMA â Protector TM , a recently introduced secondgeneration supraglottic airway device, has not been evaluated for this use in clinical trials. This prospective, randomised clinical trial compared fibreoptic-guided tracheal intubation via i-gel and LMA Protector supraglottic airway devices in two UK hospitals. Patients who were ASA physical status 1 or 2 and undergoing elective surgery requiring tracheal intubation were recruited to the study. A block randomisation list was generated for each study site. The primary outcome measure was time to successful tracheal intubation and secondary outcomes were tracheal intubation success rate, glottic view through flexible fibrescope, ease of tracheal intubation using operator visual analogue score, supraglottic airway device insertion time and insertion success rate. Ninety patients were randomly allocated to each device, and final data analysis was carried out for 92 patients in the i-gel group and 86 patients in the LMA Protector group. Mean (SD) tracheal intubation time in the i-gel and LMA Protector groups were 54.3 (13.8) s and 52.0 (13.0) s, respectively (p = 0.240). There were no significant differences in tracheal intubation success rate, glottic view and ease of tracheal intubation between the two groups. This study demonstrates that the LMA Protector supraglottic airway device is comparable to the i-gel supraglottic airway device as a conduit for fibreoptic-guided tracheal intubation.

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Section: Discussionsupporting

confidence: 70%

Fibreoptic‐guided tracheal intubation through i‐gel^® and LMA^® Protector^TM supraglottic airway devices ‐ a randomised comparison

Mendonca¹,

Tourville²,

Jefferson

et al. 2018

Anaesthesia

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“…First attempt asleep SAGFBI success rates in patients with normal airways for various SADs are 98% with an air-Q ® [47], 90–95% with an ILMA [46,47,53,54], 81% with a classic LMA 81% [45], and 100% with an i-gel ® [54]. In patients with predicted or actual difficult airways, first time success rates are 96% with an i-gel ® [49] and 97% with an air-Q ® [55]. Moreover, novices have been successful with the technique in patients with normal and difficult airways [45,56].…”

Section: Discussionmentioning

confidence: 99%

Awake supraglottic airway guided flexible bronchoscopic intubation in patients with anticipated difficult airways: a case series and narrative review

Lim

Wong

2019

Korean J Anesthesiol

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Awake intubation is indicated in a patient with a difficult airway if attempts at maintaining or securing the airway after induction of general anesthesia may encounter difficulties or result in failure, and lead to patient harm. Consideration should also be given to compounding factors, e.g., patients with severe airway obstruction, or those at risk of rapid desaturation or gastric aspiration. In rare cases, a post induction 'cannot intubate, cannot oxygenate' (CICO) scenario may develop, which is associated with severe morbidity and mortality, and the need for emergency front-of-neck access [1,2]. Indications for awake intubation include: anticipated or known difficult airway, cervical Review ArticleAwake intubation is indicated in difficult airways if attempts at securing the airway after induction of general anesthesia may lead to harm due to potential difficulties or failure in those attempts. Conventional awake flexible bronchoscopic intubation is performed via the nasal, or less commonly, oral route. Awake oral flexible bronchoscopic intubation (FBI) via a supraglottic airway device (SAD) is a less common technique; we refer to this as 'supraglottic airway guided' FBI (SAG-FBI). We describe ten cases with anticipated difficult airways in which awake SAGFBI was performed. After sedation and adequate airway topicalization, an Ambu Auragain TM SAD was inserted. A flexible bronchoscope, preloaded with a tracheal tube, was then inserted through the SAD. Finally, the tracheal tube was railroaded over the bronchoscope, through the SAD and into the trachea. The bronchoscope and the SAD were carefully removed, whilst keeping the tracheal tube in-situ. The technique was successful and well tolerated by all patients, and associated complications were rare. It also offered the advantages of performing an 'awake test insertion' of the SAD, an 'awake look' at the periglottic region, and an 'awake test ventilation. ' In certain patients, awake SAGFBI offers advantages over conventional awake FBI or awake videolaryngoscopy. More research is required to evaluate its success and failure rates, and identify associated complications. Its place in difficult airway algorithms may then be further established.

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“…Of these, 34 studies were discharged because it appeared that these studies were out of interest after reviewing the title and abstracts. The full texts of the remaining 15 studies were reviewed in more detail and 10 studies were excluded [ 2 , 5 , 20 – 27 ]. Also, by searching studies which were published after first search date (June 1, 2014), 5 more studies were found [ 11 , 12 , 14 – 16 ].…”

Section: Resultsmentioning

confidence: 99%

“…The endotracheal intubation assisted by SADs has many advantages including easy insertion, better alignment of the glottis opening, and continuous patient oxygenation and ventilation. Moreover, the haemodynamic stress response to intubation by SAD is less than that of direct laryngoscope [ 2 ]. Also, these devices can be a good alternative for patients with previous history of difficult intubation, restricted neck mobility, and stability of cervical spine [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of the Air-Q Intubating Laryngeal Airway during General Anesthesia in Pediatric Patients: A Systematic Review and Meta-Analysis

Ahn

Choi

Kang

et al. 2016

BioMed Research International

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Air-Q® (air-Q) is a supraglottic airway device which can be used as a guidance of intubation in pediatric as well as in adult patients. We evaluated the efficacy and safety of air-Q compared to other airway devices during general anesthesia in pediatric patients by conducting a systematic review and meta-analysis. A total of 10 studies including 789 patients were included in the final analysis. Compared with other supraglottic airway devices, air-Q showed no evidence for a difference in leakage pressure and insertion time. The ease of insertion was significantly lower than other supraglottic airway devices. The success rate of intubation was significantly lower than other airway devices. However, fiberoptic view was better through the air-Q than other supraglottic airway devices. Therefore, air-Q could be a safe substitute for other airway devices and may provide better fiberoptic bronchoscopic view.

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The air-Q as a conduit for fiberoptic aided tracheal intubation in adult patients undergoing cervical spine fixation: A prospective randomized study

Cited by 12 publications

References 12 publications

Fibreoptic‐guided tracheal intubation through i‐gel^® and LMA^® Protector^TM supraglottic airway devices ‐ a randomised comparison

Fibreoptic‐guided tracheal intubation through i‐gel^® and LMA^® Protector^TM supraglottic airway devices ‐ a randomised comparison

Awake supraglottic airway guided flexible bronchoscopic intubation in patients with anticipated difficult airways: a case series and narrative review

Comparative Efficacy of the Air-Q Intubating Laryngeal Airway during General Anesthesia in Pediatric Patients: A Systematic Review and Meta-Analysis

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The air-Q as a conduit for fiberoptic aided tracheal intubation in adult patients undergoing cervical spine fixation: A prospective randomized study

Cited by 12 publications

References 12 publications

Fibreoptic‐guided tracheal intubation through i‐gel® and LMA® ProtectorTM supraglottic airway devices ‐ a randomised comparison

Fibreoptic‐guided tracheal intubation through i‐gel® and LMA® ProtectorTM supraglottic airway devices ‐ a randomised comparison

Awake supraglottic airway guided flexible bronchoscopic intubation in patients with anticipated difficult airways: a case series and narrative review

Comparative Efficacy of the Air-Q Intubating Laryngeal Airway during General Anesthesia in Pediatric Patients: A Systematic Review and Meta-Analysis

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Product

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Fibreoptic‐guided tracheal intubation through i‐gel^® and LMA^® Protector^TM supraglottic airway devices ‐ a randomised comparison

Fibreoptic‐guided tracheal intubation through i‐gel^® and LMA^® Protector^TM supraglottic airway devices ‐ a randomised comparison