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BJA Advance Access originally published online on October 3, 2008
British Journal of Anaesthesia 2008 101(6):863-869; doi:10.1093/bja/aen288
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Airway Scope and gum elastic bougie with Macintosh laryngoscope for tracheal intubation in patients with simulated restricted neck mobility

R. Komatsu1, K. Kamata1, I. Hoshi2, D. I. Sessler3,* and M. Ozaki2

1 Department of Anaesthesia, Kosei Hospital, Tokyo, Japan
2 Department of Anaesthesiology, Tokyo Women's Medical University, Tokyo, Japan
3 Department of Outcomes Research, The Cleveland Clinic, 9500 Euclid Avenue, P-77, Cleveland, OH 44195, USA

* Corresponding author. E-mail: ds{at}or.org

Background: Airway Scope is a new videolaryngoscope which requires less cervical movement during intubation than direct laryngoscopy. Thus, in patients wearing a rigid cervical collar, we compared the efficacy of the Airway Scope and the gum elastic bougie with Macintosh laryngoscope during tracheal intubation.

Methods: Anaesthesia was induced with propofol, fentanyl, and rocuronium. A rigid cervical collar was applied, and patients were randomly assigned to tracheal intubation with an Airway Scope (n=48) or multiple-use gum elastic bougie with Macintosh laryngoscope (n=48). Measurements included intubation time, gum elastic bougie insertion time, intubation success rate, and insertion and intubation attempts. Airway complications were also recorded.

Results: The time required for successful intubation was significantly shorter with the Airway Scope compared with the gum elastic bougie with Macintosh laryngoscope [mean (SD) 34 (13) vs 49 (27) s, P=0.001], although the overall success rate of the Airway Scope (100%) compared with the gum elastic bougie with Macintosh laryngoscope (90%) did not reach the statistical significance (P=0.056). Oesophageal intubation (n=8) occurred only with the gum elastic bougie with Macintosh laryngoscope. Incidence of mucosal trauma and lip injury was similar with each device. No dental injury or hypoxia occurred with either device.

Conclusions: The Airway Scope shortens intubation time, is less likely to result in oesophageal intubation, and may offer a marginally higher intubation success rate in patients with simulated restricted neck mobility.

Keywords: airway; anaesthetic techniques, laryngoscopy; equipment, laryngoscopes


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This article has been cited by other articles:


Home page
 Br J AnaesthHome page
E. H. C. Liu, R. W. L. Goy, B. H. Tan, and T. Asai
Tracheal intubation with videolaryngoscopes in patients with cervical spine immobilization: a randomized trial of the Airway Scope(R) and the GlideScope(R)
Br. J. Anaesth., September 1, 2009; 103(3): 446 - 451.
[Abstract] [Full Text] [PDF]

E-letters:

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Scuring airway in patients with restricted neck mobility
Anju Gupta, et al.
British Journal of Anaesthesia, 10 Jan 2009 [Full text]
Re: Scuring airway in patients with restricted neck mobility
Ryu Komatsu, et al.
British Journal of Anaesthesia, 12 Mar 2009 [Full text]

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