Advances in airway management during the induction of anesthesia: a narrative review

Abstract

Background and Objective: This review summarizes the new techniques and devices available including high-flow nasal oxygen (HFNO) therapy, apnoeic oxygenation, video laryngeal mask, video laryngoscope (VL), flexible tip bougie (FTB), novel drugs, and artificial intelligence (AI) in airway management during the induction of anesthesia. Airway management during the induction of anesthesia is crucial and has progressed considerably in the past decade. Preoxygenation can improve oxygen reserves and extend the safe apnea time. Recently, preoxygenation via HFNO was introduced with significant success. The role of apneic oxygenation is also increasingly recognized. The combination of visualization and traditional intubation equipment has become the method of choice for anesthesiologists. Tracheal tube introducers are devices that can successfully aid airway management, especially in the difficult airway. The design and shape of these devices are constantly evolving to optimize intubation. Anesthetic are constantly updated to ensure the safety and efficiency. Remimazolam is a recently approved anesthetic. Remifentanil and dexmedetomidine are ideal drugs recommend in recently released Guidelines for Awake Tracheal Intubation (ATI) in Adults. The role of succinylcholine remains controversial and whether it can be replaced by rocuronium completely has triggered lots of researches. Finally, AI is a hot topic in medicine and it has been recently applied in airway management.