The air-Q as a conduit for fiberoptic aided tracheal intubation in adult patients undergoing cervical spine fixation: A prospective randomized study

Abstract

The air-Q™ intubating laryngeal airway is a supraglottic airway device which was designed to allow adequate patient ventilation and reliable blind endotracheal tube intubation.ObjectivesTo investigate the efficacy of air-Q as a conduit for fiberoptic endotracheal intubation in adult patients with limited cervical spine mobility compared with fiberoptic-guided intubation alone.DesignProspective randomized study.PatientsSixty adult (12 female) patients, ASA physical status I and II scheduled for cervical spine fixation under general anesthesia. Patients were randomized into two parallel groups. Exclusion criteria includes, history of difficult airway, mouth opening <3 cm, Mallampati class ⩾III and, increased risk of aspiration of gastric contents.InterventionIn the first group, endotracheal intubation was aided with the fiberoptic scope while patients in the second group were intubated with the fiberoptic scope guided with the air-Q as a conduit. The number of attempts and time to successful insertion of air-Q and endotracheal tube were recorded. The fiberoptic quality of the vocal cords view as seen through the air-Q and ease of endotracheal tube insertion were also assessed.ResultsThe air-Q was easily inserted in all patients of the second group with mean insertion time (22.6 ± 4.3 s). The air-Q provided a good fiberoptic view of the vocal cords and successful tracheal intubation in 29 (96.7%) patients of the second group on the first attempt. Time to tracheal intubation in the second group was significantly shorter than the first group (21.6 ± 5.7 and 29.8 ± 6.2 s respectively). The air-Q was easily removed without any complications.ConclusionsThe air-Q as a conduit for fiberoptic scope provided a better view of the vocal cords and, less insertion time of the endotracheal compared to fiberoptic-aided endotracheal intubation in adult patients with limited cervical spine mobility scheduled for cervical spine fixation.