Airtraq: new device in patients at increased risk for difficult tracheal intubation

Introduction

A novel single-use indirect laryngoscope, the Airtraq (A), has been demonstrated to be of promise in the normal and simulated difficult airway [1]. We compared the ease of awake intubation using the A against the fiberoptic bronchoscope (F) in patients at increased risk for difficult tracheal intubation [2].

Methods

In this randomised, controlled, clinical trial we enrolled patients at increased risk for difficult tracheal intubation, undergoing surgical operations requiring tracheal intubation. With ethics committee approval and written, informed consent, patients were randomly assigned to Fibroscope-guided tracheal intubation (F group) or Airtraq-guided intubation (A group). All patients, maintained in spontaneous breathing all through the procedure, received awake intubation performed by one of three anesthetists expert in difficult airway management. All patients received a topical airway anesthesia with 2% lidocaine and total intravenous anesthesia (TIVA) performed with propofol c.i. with an effecter site concentration of 1.5 μg/ml.

Results

We enrolled 30 patients, 15 in the F group and 15 in the A group. All patients were successfully intubated in both groups. In group A we assessed a short time and a small amount of attempts of intubation with a statistically significant difference between the two groups (P < 0.05). No difference was noted between the two groups in hemodynamic setting, saturation, Ramsey score and airway-trauma-related side effects.

Conclusions

Our experience demonstrated that the Airtraq could be used during awake sedations and may be a promising alternative device for difficult airway management as a valid alternative to the traditional fiberoptic bronchoscope.