Premium
A randomised clinical trial comparing the flexible fibrescope and the Pentax Airway Scope ( AWS ) ® for awake oral tracheal intubation
Author(s) -
Mendonca C.,
Mesbah A.,
Velayudhan A.,
Danha R.
Publication year - 2016
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.13516
Subject(s) - medicine , visual analogue scale , anesthesia , remifentanil , midazolam , intubation , lidocaine , airway , tracheal intubation , sedation , surgery , propofol
Summary We compared awake fibreoptic intubation with awake intubation using the Pentax Airway Scope ® in 40 adult patients. Sedation was achieved using a target‐controlled remifentanil infusion of 1–5 ng.ml −1 and midazolam. The airway was anaesthetised with lidocaine spray and gargle. The total procedure time – a composite of sedation time, topical anaesthesia time and intubation time – was recorded. The operator's impression of the ease of the procedure and the patients' reported comfort were recorded on a 0–100 mm visual analogue scale. The median (IQR [range]) for total procedure time was 900 (739–1059 [616–1215]) s with the fibrescope and 651 (601–720 [498–900]) s with the Pentax Airway Scope (p = 0.0001). The median (IQR [range]) intubation time was 420 (283–480 [120–608]) s with the fibrescope and 183 (144–220 [107–420]) s with the Pentax Airway Scope (p = 0.0002). The median (IQR [range]) visual analogue scores for the operator's ease of intubation for the fibrescope and Pentax Airway Scope were 83.6 (72.0–98.0 [49.0–100.0]) and 86.8 (84.0–91.0 [61.0–100.0]), respectively (p = 0.3507). The median (IQR [range]) visual analogue score for patient comfort was 85.5 (81.0–97.0 [69.0–100.0]) and 79.4 (74.0–85.0 [59.0–100.0]) for the fibrescope and Pentax Airway Scope, respectively (p = 0.06). Total procedure time was significantly shorter with the Pentax Airway Scope compared with the fibrescope, with no difference in procedure difficulty or patient discomfort.