Simulation study of nasotracheal and orotracheal fiberoptic intubation with the Aintree Intubation Catheter.

Abstract

Fiber-optic tracheal intubation is an essential technique to secure the airway for difficult airway and cervical cord injury victims. However, there is an anxiety about the vocal cord passage of tracheal tubes because of the potential of collision with the surroundings of the vocal cords. This study aimed to examine the utility of the Aintree Intubation Catheter in nasotracheal and orotracheal intubation. Participants were 21 anesthesiologists with more than 2 years of experience in clinical anesthesia. Participants attempted fiber-optic tracheal intubation through the oral or nasal cavity with or without the Aintree Intubation Catheter in random order. The success rate of tracheal intubation, intubation time, and collision with the glottis were recorded. Participants also evaluated the subjective difficulty of the entire intubation process and passing the tracheal tube through the glottis using a Visual Analogue Scale. There were no significant differences in intubation time or Visual Analogue Scale scores for passing the tracheal tube through the glottis between nasal and oral intubation, regardless of the use of the Aintree Intubation Catheter. However, the catheter significantly reduced the number of collisions with the glottis in both routes (nasal, P = 0.026; oral, P = 0.017). Our findings that the Aintree Intubation Catheter is effective in reducing collisions with the glottis during nasal and oral fiber-optic intubation suggest that Aintree Intubation Catheter use may reduce the risk of mechanical injury related to airway obstruction.