Intubation through a supraglottic airway device with cervical spine immobilisation: a comparison between the intubating laryngeal mask airway and the intubating laryngeal tube used by novices - a manikin study.

Abstract

Objectives. Supraglottic airway devices play an important role during airway management of trauma patients with suspected or present injury to the cervical spine. The aim of this study was to evaluate the Intubating Laryngeal Mask Airway (ILMA) and the new Intubating Laryngeal Tube in the hands of residents with minimal previous intubation experience during simulated conditions of reduced cervical spine mobility. Methods. Thirty first year anaesthetic trainees participated in the study (F=18, M=12). The time required to insert the supraglottic airway device and ventilate through it as well as the insertion to intubation and successful ventilation time were recorded. Efficacy of intubation and the ease of use by the operator were also assessed. The two devices were used by each participant and they were randomly chosen. All trainees participating in the study had minimal intubation experience (<10 intubations previously performed) and were novices in this field. Results. The mean time required to insert the supraglottic airway device and ventilate through it was similar for both of the studied devices (p=0.9384). The Intubating Laryngeal Tube had the shortest insertion to intubation and successful ventilation time 25.41 s (±8.62) vs. 31.92 s (±8.82), p<0.05. There were no failed intubation attempts when the Intubating Laryngeal Tube was used. Conclusions. The new Intubating Laryngeal Tube may be a good alternative to the ILMA as it shortens the time required to intubate and successfully ventilate the patient. It also improves the rate of successful intubation. Key words: supraglottic airway device, intubation, manikin study, cervical spine immobilisation, novices