Critical Care S Tomasino, Alto Friuli, Tolmezzo, Udine, Italy
In this randomised, controlled, clinical trial authors enrolled 30 patients at increased risk for difficult tracheal intubation, undergoing surgical operations requiring tracheal intubation.
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.
All patients were successfully intubated in both groups. In Airtraq group the authors assessed a short time and a small amount of attempts of intubation with a statistically significant difference between the two groups. 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.
Canadian Anesthesiologists Soc , F.S. Xue, , Chinese Academy of Medical Sciences
The authors describe our initial experience with a method of airway topical anesthesia for awake tracheal intubation in adult patients with difficult airways using a combination of an Airtraq laryngoscope and a MADgic laryngotracheal atomizer.
Once the distal end of the Airtraq laryngoscope was positioned in the vallecula with the glottis in the center of the viewfinder, the curved applicator portion of a MAD-LTA was advanced through the lateral channel of the Airtraq. By adjusting the distant position of the applicator portion under direct vision on the viewfinder, its tip was placed immediately superior to the glottis and the bilateral pyriform recess. Then, 3 mL of 2% lidocaine was sprayed in three aliquots onto these targeted areas with the MAD-LTA.
Several advantages appear to exist with this technique: the applicator portion of the MAD-LTA can well be adapted to the curved blade of the Airtraq / the MAD-LTA can be directed easily towards the different targeted airway structures / this approach can provide excellent airway topical anesthesia for awake orotracheal intubation / this technique is well tolerated by the awake, sedated patient / this technique is easy to perform.
Therefore, the authors believe this technique can provide a favourable alternative to a fiberoptic technique for the management of difficult airways.
Request a FREE on-site demonstration from a local Airtraq Sales Representative.