Air-Q the Intubating Laryngeal Airway: Comparative study of hemodynamic stress responses to tracheal intubation via Air-Q and direct laryngoscopy

Abstract

Background: Tracheal intubation is the gold standard for securing airway. Tracheal intubation through DLS produces marked hemodynamic stress responses. The Air-Q is a new supraglottic airway device. The purpose of this study was to determine whether endotracheal intubation through Air-Q is associated with lesser hemodynamic stress responses.Methods: 60 patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation were randomly assigned into two groups. Direct laryngoscopy group and Air-Q group. Blood pressure and heart rate were recorded before, after induction, immediately after intubation and every minute for 4 min after intubation. The intubation time was recorded. Upon removal of the Air-Q, trauma to the upper airway was reported.Results: The intubation time was shorter in the DLS group compared with the Air-Q group (P value < 0.05). A significant reduction in BP was evident after the induction of anesthesia in both groups. Immediately after intubation, there was a significant increase in BP compared with the preintubation values. A decline was inspected between 1 and 4 min postintubation in both groups with significant difference immediately, at 1 and 2 min postintubation between the two groups. There were significant increase in HR immediately, at 1 and 2 min postintubation compared with the preintubation values, but there was no significant difference at each time point between two groups. Sore throat was more in the Air-Q group (P value <0.05).Conclusion: The hemodynamic stress response to intubation by Air-Q is less than that of DLS despite the longer duration of the former.