Comparison of the air-Q intubating laryngeal airway versus the modified Williams intubating airway as aids for training in fiberoptic tracheal intubation

• Published in: Ain-Shams journal of anesthesiology 2013-04, Vol.6 (2), p.134-139
• Main Authors: Abbas, Dina N., Abd al-Ghaffar, Ikrami M.
• Format: Article
• Language: English
• Subjects: Airway (Medicine); Bronchoscopy; Instruments; Intubation; Optical fibers in medicine; Trachea; التنفس
• ISSN: 1687-7934; 2090-925X

Objective The fiberoptic bronchoscope (FOB) is one of the most common instruments used for intubating the trachea. This study assesses the effectiveness of a training program for novice anesthetists by assessing the performance and success rate of fiberopticguided tracheal tube placement using the air-Q or the modified Williams airway. Methods A total of 100 patients were randomly assigned to one of two groups: in group A, FOB tracheal intubation was performed guided with an air-Q intubating laryngeal airway, and in group B, FOB intubation was performed guided with a modifiedWilliams airway (under patency). Induction and intubation time were measured. Incidence of obstructed bronchoscopic view and ease of fiberoptic intubation were determined, postoperative patient and anesthesiologist questionnaires were administered, and complications were recorded. Results The time required for induction of anesthesia, airway insertion, and intubation was significantly lower in group B than in group A. The number of patients intubated by the primary anesthesiologist was higher in group B than in group A. There was significantly lower tube hold up in group B than in group A. Anesthesiologists were significantly more comfortable with the use of the modified Williams airway. There was no statistically significant difference in the occurrence of sore throat and hoarseness between both groups; the incidence of airway injury (visible macroscopic blood stains on device removal) was higher in the air-Q group than in the modified Williams group, but it was not statistically significant. Conclusion Novices could be taught fiberoptic intubation more easily with the aid of the modified Williams airway than with the aid of air-Q under similar conditions. The safety and effectiveness of this training regimen using either airway recommend it for inclusion in any residency program