Efficacy of the Airtraq® laryngoscope with a fiberoptic bronchoscope compared with that of Airtraq® alone for tracheal intubation: a manikin study

Abstract

Successful intubation using the Airtraq(®) requires optimal positioning of the glottis in the middle of the viewfinder. If the glottic view cannot be optimized, some glottic manipulation is essential for the Airtraq-assisted successful intubation. We evaluated the efficacy of the combined use of the Airtraq and a fiberoptic bronchoscope (FOB) compared with that of the Airtraq alone for tracheal intubation in simulated airway scenarios. Eight anesthesia providers (four staff and four residents) were enrolled in this study. The participants intubated the trachea of the ALS Simulator manikin in five tongue edema scenarios simulating modified Cormack-Lehane grade 1, 2a, 2b, 3, and 4 views and one cervical immobilization scenario. No significant difference in the rate of successful intubation was detected between the combined use and the use of Airtraq alone in all scenarios. However, the duration of intubation attempts with the combined use was significantly shorter in difficult laryngoscopy scenarios (Cormack-Lehane grade 2b-4) (P<0.01) and were significantly longer in easy laryngoscopy scenarios (grade 1 and 2a) (P<0.05) than those with Airtraq alone. The rate of successful intubation and duration of intubation attempts were similar between the anesthetists and residents in each intubation technique in all scenarios. The combined use of Airtraq(®) and a FOB enables rapid intubation in simulated difficult airway scenarios compared with intubation using Airtraq alone, and the speed of intubation performed by anesthetists and residents is similar in all airway scenarios.