Tracheal intubation by non-anesthesia residents using the Pentax-AWS airway scope and Macintosh laryngoscope

Abstract

Study Objective To evaluate the performance of the Pentax-AWS airway scope for tracheal intubation compared with the Macintosh laryngoscope by non-anesthesia residents. Design Prospective, randomized, cohort study. Setting University-affiliated hospital. Patients 520 patients who underwent tracheal intubation for general anesthesia. Interventions 48 non-anesthesia residents performed tracheal intubation using either the Pentax-AWS or the Macintosh laryngoscope. Measurements Time to complete tracheal intubation, number of attempts until successful intubation, and number of intubations of the esophagus were recorded. Results Time to secure the airway (sec; mean ± SD) was shorter with the Pentax-AWS than with the Macintosh laryngoscope (44 ± 19 vs. 71 ± 44 sec; P < 0.001). Of the 264 tracheal intubations with the Pentax-AWS, 239 (91%) were completed within 60 seconds, while only 148 (58%) of the 256 tracheal intubations performed with the Macintosh laryngoscope were completed within the same period. The rate of successful intubations on the first attempt was higher with the Pentax-AWS than the Macintosh laryngoscope ( P < 0.001). No esophageal intubation was experienced with the Pentax-AWS approach, while 18 occurred with the Macintosh laryngoscope ( P < 0.001). Conclusion The Pentax-AWS appears to require less operator skill than the Macintosh laryngoscope. Use of the Pentax-AWS may reduce the time to secure the airway and the incidence of failed tracheal intubation by non-anesthesia residents.