Evaluation of air-Q™ intubating laryngeal airway as a conduit for tracheal intubation in infants--a pilot study

Paediatr Anaesth. 2012 Feb;22(2):156-60. doi: 10.1111/j.1460-9592.2011.03710.x.

Abstract

Background: Air-Q™ intubating laryngeal airway (ILA) has been used successfully as a conduit for tracheal intubation in pediatric difficult airway. However, its use as an airway device and conduit for intubation in infants is not yet evaluated.

Aims: The primary objective was to evaluate ILA as a conduit for tracheal intubation in infants, and secondary objectives were to evaluate ILA in terms of ease of insertion and ventilation, oropharyngeal leak pressure (OLP), glottic view, and complications.

Methods: Twenty infants with normal airway were included. After induction of general anesthesia and neuromuscular blockade, ILA (size 1.0/1.5) was inserted. Fiberoptic bronchoscope (FOB)-guided intubation and removal of ILA with the stabilizing stylet was attempted.

Results: The mean age and weight of the infants were 7.5 ± 2.3 months and 7.3 ± 1.8 kg. The ILA sizes 1.0 and 1.5 were inserted in 10 infants each according to the weight of the infants. The mean OLP was 18.5 ± 1.8 cm H₂O, and mean time for insertion of ILA was 13.3 ± 3.9 s. Glottic view was grade I in 6, grade II in 1, grade III in 4, and grade IV in nine infants. Tracheal intubation was successful in 19/20 infants. The mean endotracheal tube (ETT) insertion time and mean total time (ILA insertion to the confirmation of ETT placement) were 95.6 ± 32.3 s and 306.42 ± 120.2 s respectively.

Conclusion: The ILA is a safe and easy-to-use supraglottic airway device for intubation with FOB in infants with normal airway. Insertion and removal of ILA are easy with satisfactory oropharyngeal seal and ventilation.

Publication types

  • Evaluation Study

MeSH terms

  • Airway Extubation
  • Airway Management
  • Anesthesia, General
  • Anesthetics, Inhalation
  • Bronchoscopy
  • Female
  • Fiber Optic Technology
  • Glottis / anatomy & histology
  • Humans
  • Infant
  • Intubation, Intratracheal / adverse effects
  • Intubation, Intratracheal / instrumentation*
  • Intubation, Intratracheal / methods*
  • Isoflurane
  • Laryngeal Masks* / adverse effects
  • Laryngoscopy
  • Male
  • Monitoring, Intraoperative
  • Nitrous Oxide
  • Pilot Projects
  • Respiration, Artificial
  • Vocal Cords / anatomy & histology

Substances

  • Anesthetics, Inhalation
  • Isoflurane
  • Nitrous Oxide