Comparison between three supraglottic airway devices as conduits for fiber-optic tracheal intubation

Abstract

Background Securing the airway is a major task for anesthesiologists. Supraglottic airway devices (SADs) are widely used nowadays. Fiber-optic endotracheal intubation (ETT) plays an important role in difficult-to-manage airways. The general purpose of a conduit is to provide a clear protected pathway for the expensive, sensitive, and fragile fiber-optic cable. Aimof the work To compare between three SADs as conduits for fiber-optic tracheal intubation. Patients and methods A prospective, randomized study involving 81 adult patients (American Society of Anesthesiologists I or II), of both sexes who were allocated into three groups (27 patients each): Air-Q group (group Q), intubating laryngeal mask airway (ILMA) group (group L) or I-Gel group (group G). Fiber-optic ETT through SADs was performed. The number of attempts and duration of insertion of SAD, laryngeal view grading, number of attempts, and duration of insertion of ETT were assessed. Complications were recorded. Results The ease and number of attempts to insert SADs showed no statistically significant differences. The duration of insertion of SADs was statistically favoring the Air-Q intubating laryngeal airway (13±3 s), compared with ILMA (19±4 s) and I-Gel (18±3 s). The fiber-optic grading of laryngeal view through SADs also favored group Q compared with other groups. Number of attempts to insert ETT through SADs showed no statistically significant differences between groups. The duration of insertion of the ETT via fiber-optic bronchoscopic through the SADs showed highly statistically significant difference (P Conclusion Air-Q, ILMA, and I-Gel were useful conduits for fiber-optic ETT. Air-Q intubating laryngeal airway provides better visualization of the glottis and shorter time for insertion of both the device and the ETT than ILMA and I-Gel.