Blind versus fiberoptic laryngoscopic intubation through air Q laryngeal mask airway

摘要

Background The practice of airway management has become more advanced in recent years. This advancement is demonstrated by the introduction of many new airway devices, several of which have been included in the American Society of Anesthesiology (ASA). The most recently developed is air-Q which has special features and benefits that make it characteristic. The success rate of blind intubation versus fiberoptic intubation through air-Q was investigated in this study. Success rate and quality of fiberoptic guided intubations were assessed. Method This study was conducted on 80 patients who underwent urosurgical operations under general anesthesia. Patients were randomly allocated into two equal groups ( n = 40): group I in which intubation was done blindly through air-Q, and group II in which intubation was done by FO through air-Q. All the patients were meticulously assessed by El Ganzouri score. Patients taking points from 0 to 4 were only allowed to be included in this study to avoid the use of the awake technique if the score was 5 or more. After induction of anesthesia patients were primarily ventilated with the air Q. Then the endotracheal tube was inserted either blindly or by FO through the air Q. Successful intubation was confirmed by chest wall movement, auscultation, and capnogram. After three trials of intubations the procedure was abandoned. Twenty-four hours post-intubation, patients were questioned on the occurrence of sore throat and hoarseness. Results The success rate in blind intubation was 70% while in FO intubation was 97.5%.and this difference was statistically significant ( p 0.05). The total time to intubate in seconds was longer in group I than in group II and this difference was statistically significant ( p 0.05). Conclusion In our patients the air Q appeared to be a safe supraglottic airway in general anesthesia with a low potential for trauma of the airway. It is used as a facilitator for blind intubation. It allowed successful blind intubation in 70% of the patients versus 97.5% using fiberoptic technique. Backed up by the presence of a flexible fiberscope, this device might be a useful alternative for the handling of difficult airway.