OJAnes  Vol.4 No.5 , May 2014
Fiberoptic Intubation through Adapter Removable Supraglottic Airways; Comparison of the Air-Q ILATM, LMA Classic ExcelTM, and LMA UniqueTM
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 ILATM, LMA Classic ExcelTM, and LMA UniqueTM. 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 ILATM, LMA Classic ExcelTM, and LMA UniqueTM 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 ILATM provides the best view of the larynx and is the easiest one to use as an intubation conduit.
Cite this paper: Lee, A. and Benumof, J. (2014) Fiberoptic Intubation through Adapter Removable Supraglottic Airways; Comparison of the Air-Q ILATM, LMA Classic ExcelTM, and LMA UniqueTM. Open Journal of Anesthesiology, 4, 111-118. doi: 10.4236/ojanes.2014.45017.

[1]   Benumof, J.L. (1996) Laryngeal Mask Airway and the ASA Difficult Airway Algorithm. Anesthesiology, 84, 686-699.

[2]   Hagberg, C.A. (2013) Current Concepts in the Management of the Difficult Airway. Anesthesiology News, May 2013.

[3]   Roth, D. and Benumof, J.L. (1996) Intubation through a Laryngeal Mask Airway with a Nasal RAE Tube: Stabilization of the Proximal End of the Tube. Anesthesiology, 85, 1220.

[4]   Caplan, R.A., Benumof, J.L., et al. (2003) Practice Guidelines for Management of the Difficult Airway. Anesthesiology, 98, 1269-1277.

[5]   Halwagi, A.E., Massicotte, N., Lallo, A., Gauthier, A., Boudreault, D., Ruel, M. and Girard, F. (2012) Tracheal Intubation through the I-GelTM Supraglottic Airway versus the LMA FastrachTM: A Randomized Controlled Trial. Anesthesia & Analgesia, 114, 152-156.

[6]   Baskett, P.J., Parr, M.J. and Nolan, J.P. (1998) The Intubating Laryngeal Mask: Results of a Multicenter Trial with Experience of 500 Cases. Anaesthesia, 53, 1174-1179.

[7]   Cook, T.M., Silsby, J. and Simpson, T.P. (2005) Airway Rescue in Acute Upper Airway Obstruction Using a ProsealTM Laryngeal Mask Airway and an Aintree CatheterTM: A Review of the ProsealTM Laryngeal Mask Airway in the Management of the Difficult Airway. Anesthesia, 60, 1129-1136.

[8]   Wong, D.T., Yang, J.J., Mak, H.Y. and Jagannathan, N. (2012) Use of Intubation Introducers through a Superglottic Airway to Facilitate Tracheal Intubation: A Brief Review. Canadian Journal of Anesthesia, 59, 704-715.