Fiberoptic Intubation through Adapter Removable Supraglottic Airways; Comparison of the Air-Q ILA^TM, LMA Classic Excel^TM, and LMA Unique^TM

Alvin Y. Lee, Jonathan L. Benumof

UCSD Medical Center, Department of Anesthesiology, San Diego, USA.

DOI: 10.4236/ojanes.2014.45017                

Abstract

Study Objective: We studied the overall efficacy of fiberoptic aided intubation using three different supraglottic airways (SGA) as intubation conduits with a standard endotracheal tube (ETT) to determine which, if any, is superior as an intubation conduit. Design: After induction of general anesthesia, subjects were randomized to one of three groups: Air-Q ILA^TM, LMA Classic Excel^TM, and LMA Unique^TM. Subjects were intubated with a fiberoptic aided technique with continuous ventilation with FiO₂ = 1.0 through one of these SGAs. The primary endpoint was the overall efficacy of the intubation procedure. In addition, the following data were collected: demographic data, intubation times, grade of view of the larynx, and a visual analog scale (VAS) score of difficulty as determined by the primary anesthesiologist performing the procedure. Data were analyzed using a Kruskal-Wallis one-way analysis of variance and Post hoc analysis was done using Dunn’s Multiple Comparison Test. Results: 126 total subjects were studied. Intubation success rates were 100%, 87.8%, and 95% with the Air-Q ILA^TM, LMA Classic Excel^TM, and LMA Unique^TM respectively. There was no significant difference among the three different SGAs when comparing the times to place the SGA (T1), the true intubating time (T2), the time to remove the SGA (T3), or the total time (T4). Data were also stratified by the grade of view of the larynx; all grade I views, grade II views, and grade III views were grouped together regardless of the type of the SGA used. The grade I view of the larynx group had significantly faster true intubation times (T2 = 75.1 sec, p = 0.01) and significantly lower VAS scores (VAS = 1.9, P = < 0.0001) when compared to both the grade II views (T2= 92.7 sec, VAS = 3.2) and grade III views (T2 = 111.6 sec, VAS = 4.9). Conclusions: We conclude that the Air-Q ILA^TM provides the best view of the larynx and is the easiest one to use as an intubation conduit.

Keywords

Fiberoptic Intubation, Laryngeal Mask Airway, Supraglottic Airway

Conflicts of Interest

The authors declare no conflicts of interest.

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