Abstract
ABSTRACTBackground: Many oral airways are used for aiding fiberoptic bronchoscope (FOB)-guided endotracheal intubation. This study was done to evaluate modified William’s airway, modified Guedel’s airway, and LMA MADgic airway as conduits for FOB-guided endotracheal intubation.Methods: Sixty patients presented for elective surgery under general anesthesia were randomly allocated into three groups: Modified Guedel’s airway group (GG), modified Williams airway group (GW), and LMA MADgic airway group (GM). The three study groups were compared with regard to time of insertion of the airway, time of intubation, ease of airway insertion, number of intubation attempts, Laryngeal View Grade (LVG), and the incidence of complications.Results: Gw had shorter time of airway insertion, shorter time of intubation, lower number of intubation attempts, and better laryngeal view compared to GG and GM. The anesthesiologist was more comfortable in Gw compared to the other two groups.The incidence of complications (sore throat, and blood-stained airway) was comparable between the three groups.Conclusion: Modified Williams airway provided shorter time of endotracheal tube intubation, and lower number of intubation attempts in comparison to modified Guedel’s airway and LMA MADgic airway when used as conduit for FOB-guided endotracheal intubation. This randomized controlled study was conducted in Cairo University Hospital. Research Ethics Committee approved the study (N-40–2016).
Highlights
Fiberoptic bronchoscope (FOB) is an important tool for tracheal intubation
The use of oropharyngeal airways as a conduit for fiberoptic bronchoscope (FOB)-guided endotracheal intubation would allow the FOB to reach the laryngeal cavity in shorter time by bypassing the oral cavity and the soft palate [1]
Several oropharyngeal airways are available used for assistance of fiber optic intubation (FOI) such as Ovassapian, Wiliams, Berman, LMAMADgic, modified Guedel’s, and modified William’s airways [2]
Summary
Fiberoptic bronchoscope (FOB) is an important tool for tracheal intubation. The use of oropharyngeal airways as a conduit for FOB-guided endotracheal intubation would allow the FOB to reach the laryngeal cavity in shorter time by bypassing the oral cavity and the soft palate [1].Several oropharyngeal airways are available used for assistance of fiber optic intubation (FOI) such as Ovassapian, Wiliams, Berman, LMAMADgic, modified Guedel’s, and modified William’s airways [2]. The use of oropharyngeal airways as a conduit for FOB-guided endotracheal intubation would allow the FOB to reach the laryngeal cavity in shorter time by bypassing the oral cavity and the soft palate [1]. The modifications of Williams [2] and Guedel’s airways [3] are based on introducing a cleft in the lingual surface of both airways to allow removal of the airway after ETT insertion. The early removal of the airway would decrease the risk of pharyngeal or oral injury, and would enable one-step ETT insertion and shortened the intubation time and the duration of apnea. Many oral airways are used for aiding fiberoptic bronchoscope (FOB)-guided endotracheal intubation. This study was done to evaluate modified William’s airway, modified Guedel’s airway, and LMA MADgic airway as conduits for FOB-guided endotracheal intubation
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