Comparison of the Air-Q intubating laryngeal mask airway and the Ambu AuraGain laryngeal mask airway as aconduit for fibreoptic assisted endotracheal intubation for simulated cervical spine injury.

Abstract

Airway management in patients with acervical spine injury is adifficult and challenging task. The aim of this study was to compare the effectiveness of the Air-Q intubating laryngeal airway and the Ambu AuraGain laryngeal mask airway as aconduit for fibreoptic (FO) assisted endotracheal intubation in adult patients with asimulated cervical spine injury. Atotal of 66 adult patients underwent elective surgery under general anaes-thesia, and they were randomized to two groups: the Air-Q (AQ) group (n = 33) and the Ambu AuraGain (AA) group (n = 33). Asimulated cervical spine injury was created using acervical collar, which was applied after the induction of general anaesthesia. Ease of insertion, time taken for successful insertion, time taken for successful FO guided endotracheal intubation, oropharyngeal leak pressure (OLP), Brimacombe score for FO laryngeal view, post-intubation complications and haemodynamic changes were recorded for both groups. The OLP was significantly higher in the AA group than in the AQ group (34.9 ± 6.4 vs. 28.6 ± 7.8 cm H 2 O; P = 0.001). Otherwise, there were no significant differences in the ease of insertion, time taken for successful insertion, time taken for successful FO guided endotracheal intubation, Brimacombe score for FO laryngeal view, haemodynamic parameters or complication rate between the two groups. Air-Q was comparably effective as Ambu AuraGain as aconduit for FO endotracheal intubation in patients with asimulated cervical spine injury; however, Ambu AuraGain has abetter seal with significant OLP.