Use of the Airtraq® optical laryngoscope for nasotracheal intubation in predicted difficult airway management in oral surgery

Gómez-Ríos, Manuel Ángel; Serradilla, Laura Nieto

doi:10.1007/s12630-010-9390-5

Cited by 12 publications

(5 citation statements)

References 6 publications

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“…Consistent with our results, there was a recently published awake nasotracheal intubation case with an oral cancer with Mallampati IV using the Airtraq NT through the right nostril at the first attempt without the need of any maneuvers or Magill forceps (18).…”

Section: Discussionsupporting

confidence: 92%

“…There are few studies and even case reports published in difficult nasotracheal intubation situations. When we read them, we saw that all successful intubations were performed from the right nostril with the Airtraq NT and McGrath MAC and with help of the 90° counterclockwise rotation maneuver (7,18,26). The limitation of our study is as follows; the operators were not blind to the selected nostrils and our patients were not expected to be difficult intubation patients.…”

Section: Discussionmentioning

confidence: 99%

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Which nostril should be used for nasotracheal intubation with Airtraq NT?: the right or left? A randomized clinical trial

Arslan¹,

Türkyılmaz²

2019

Turk J Med Sci

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Background and aim: Nasotracheal Airtraq, is specifically designed to improve the glottis view and ease the nasotracheal intubation process in normal and difficult cases. Materials and methods: After Ethics committee approval, we decided to enroll 40 patients with an ASA physical status of I or II, between 18-70 years of age undergoing elective maxillofascial, oral and double chin surgery to determine which nostril is more suitable for nasotracheal intubation with nasotracheal Airtraq. Patients were randomised into the right and left nostril groups. Results: Demographic and airway characteristics were similar among the groups. Nasotracheal intubation through the right nostril was shorter than that of the left nostril during nasotracheal intubation with the Airtraq NT (p<0.001). 90 anti-clockwise rotation of the tip of the tube was needed for directing the tube into the vocal cords in both right and left nostril groups (72% vs 88%). External laryngeal pressure and head flexion maneuvers can ease the intubation from the left nostril (p<0.001 vs p=0.03). Cuff inflation maneuver also can be helpful in some cases. We did not need any operator change or Magill forceps for any of the patients. Conclusion: Nasotracheal intubation via the right nostril can be safely and quickly performed with the Airtraq NT without the need of Magill forceps. We recommend the use of the 90 anti-clockwise rotation, external laryngeal pressure and head flexion maneuvers to direct the tube into the vocal cords first. On the other hand; cuff inflation maneuver also must be kept in mind. Keywords: Airtraq, nasotracheal, right nostril, 90 degree anticlockwise, cricoid pressure, head flexion

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Which nostril should be used for nasotracheal intubation with Airtraq NT?: the right or left? A randomized clinical trial

Arslan¹,

Türkyılmaz²

2019

Turk J Med Sci

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“…This necessitates alignment of the oropharyngeallaryngeal axes for visualisation of the glottis and tracheal intubation 3 ; and may fail or be poorly tolerated by an awake patient with a 'difficult airway', resulting in morbidity and even mortality. 4 Use of a fibreoptic bronchoscope has been recommended in this scenario, but this device is often unavailable and the technique is less familiar and requires additional skill and training to be used effectively, 5,6 making alternatives necessary.…”

Section: Introductionmentioning

confidence: 99%

A randomised crossover trial comparing the Airtraq® NT, McGrath® MAC and Macintosh laryngoscopes for nasotracheal intubation of simulated easy and difficult airways in a manikin

Gómez-Ríos

Pinegger

Mantilla

et al. 2016

Brazilian Journal of Anesthesiology (English Edition)

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“…1 A wider range of applications of Airtraq ® have been described in literature including difficult airway management, as a rescue device following failed direct laryngoscopy, awake tracheal intubation, airway management of patients with morbid obesity as well as those with unstable cervical spine, and airway management in pre-hospital setings. [2][3][4][5][6][7][8] Failed intubation using Airtraq ® may be encountered owing to difficulty or inability to manipulate the endotracheal tube (ETT) tip across the glottis. 9 Gum elastic bougie (GEB) can be used as a rescue device in such cases.…”

Section: Introductionmentioning

confidence: 99%

Comparison of two methods of gum elastic bougie aided endotracheal intubation using Airtraq® video laryngoscope

Muhamed

Narasimha

Mathew

et al. 2017

Sri Lankan J Anaesthesiol

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This study was conducted to compare two methods of gum elastic bougie (GEB) aided endotracheal intubation using Airtraq ® video laryngoscope. Materials and method: In this prospective study, sixty patients undergoing elective surgery under general anaesthesia were randomly allocated into two groups. In Group P, Airtraq ® was preloaded with endotracheal tube (ETT) with the GEB placed inside it up to the tip and the entire assembly is passed en bloc into the mouth. On visualisation of the glottis, the GEB is initially advanced across the glottis followed by railroading the ETT into the trachea. In Group S, GEB was introduced separately from the side after visualisation of the glottis using Airtraq ® , followed by railroading the ETT over the GEB. Time taken for successful insertion of GEB, ease of insertion of GEB, time taken and number of attempts at endotracheal intubation were noted. Results: As the data for time taken for GEB insertion were skewed, the statistical analysis was done using Mann-Whitney U test and median, 25 th and 75 th percentile values were calculated. Time taken for GEB insertion and endotracheal intubation was found to be shorter in Group P than in Group S, both the results being statistically significant. The time taken for GEB insertion was 7.71 seconds (median) in Group P and 20.44 seconds (median) in Group S, whereas time taken for endotracheal intubation was 14.68 ± 0.913 seconds vs. 29.10 ± 1.83 in Group P and Group S respectively. Conclusion: The use of GEB preloaded into the ETT or insertion of the same from the side of the mouth while using Airtraq ® proves to be a clinically effective alternative to achieve successful endotracheal intubation. Time taken to achieve successful endotracheal intubation is shorter if the GEB is preloaded into the endotracheal tube. Additional manoeuvres like external laryngeal manipulation will help in GEB advancement especially when it is inserted from the side of the mouth using Airtraq ®

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Use of the Airtraq® optical laryngoscope for nasotracheal intubation in predicted difficult airway management in oral surgery

Cited by 12 publications

References 6 publications

Which nostril should be used for nasotracheal intubation with Airtraq NT?: the right or left? A randomized clinical trial

Which nostril should be used for nasotracheal intubation with Airtraq NT?: the right or left? A randomized clinical trial

A randomised crossover trial comparing the Airtraq® NT, McGrath® MAC and Macintosh laryngoscopes for nasotracheal intubation of simulated easy and difficult airways in a manikin

Comparison of two methods of gum elastic bougie aided endotracheal intubation using Airtraq® video laryngoscope

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