Comparative Study of Orotracheal Intubation through Air Q Laryngeal Mask Airway: Blind Versus Fiberoptic Guided During General Anesthesia

Abstract

Abstract This study was designed to compare the hemodynamic and arousal responses to blind orotracheal intubation through Air Q laryngeal mask airway versus flexible fiberoptic guided. 100 adult patients ASA I and II undergoing elective surgeries under general anesthesia with orotracheal intubation were divided into two groups according to the technique of intubation through Air-Q ILA Group І (n= 50) patients intubated blindly through Air-Q ILA Group ІІ (n=50) patients intubated through Air-Q ILA guided by flexible fiberoptic bronchoscope. The following parameters were recorded: heart rate, systolic, diastolic and mean arterial blood pressure and Bispectral Index (BIS) values: preinduction, after induction of anesthesia, then at 1 and 5 minutes after intubation, arterial oxygen saturation (SpO 2 ): before, during and after intubation, time of insertion(in seconds) and number of attempts of insertion of the endotracheal tube and airway complications; injury to the gums or teeth damage, hoarseness of the voice, bleeding, sore throat. Systolic and mean arterial blood pressures were statistically significant lower in the fiberoptic group than the blind group. There was no statistically significant difference between the two groups in the heart rate and diastolic blood pressure.There was statistically significant lower time of intubation and less number of attempts in fiberoptic group than in blind group, the success rate of intubation in the fiberoptic group was 100% compared to 76% in blind group. There was statistically significant lower BIS value in the fiberoptic group 1 minute after intubation than in the blind group. Endotracheal intubation through the Air-Q ILA guided by flexible fiberoptic bronchoscope is associated with less hemodynamic and arousal responses than blind endotracheal intubation through the Air-Q ILA, the number of attempt and time of successful intubation were statistically significantly lower in the fiberoptic group than the blind group. Key Words: Air Q Laryngeal Mask Airway, Fiberoptic bronchoscope, pressor response, arousable response