Air-Q versus LMA Fastrach™ for fiberoptic-guided intubation: A randomized cross-over manikin trial.

Introduction: Airway management is still a major cause of anesthesia-associated morbidity and mortality. Supraglottic devices are recommended in difficult airway management guidelines. The aim of this study was to compare the performance of the Air-Q and the LMA Fastrach™ for fiberoptic guided tracheal intubation.

Methods: Thirty-three anesthesia trainees participated in this randomized crossover study. Time to insert the dedicated airways (insertion of the airway into the manikin and delivery of two breaths), time to tracheal intubation (fiberoptic-guided tracheal intubation), time to remove the dedicated airway (removal of the Air-Q/LMA Fastrach™ over the tracheal tube) and the opinion of the ease of use of the anesthesia trainees were measured.

Results: There was 100% success rate for tracheal intubation with both devices on the first attempt. Time to insert the dedicated device and deliver two breaths was 10±3s for the Air-Q and 11±3s for the LMA Fastrach™, P=.07. Time taken to intubate the trachea was shorter with the air-Q, 38±15 s, than with the LMA Fastrach™, 47±19s, P=.017. Overall procedure time was significantly shorter with the Air-Q as compared with the LMA Fastrach™, with a mean time of 74±21s and 87±28s respectively, P=.002. Air-Q removal was considered easier than LMA Fastrach™ removal, P=.005. There were no tube dislodgements during the removal of the dedicated airways.

Conclusions: Inexperienced anesthesia residents can perform fiberoptic-guided intubation through Air-Q and LMA Fastrach™ in a clinically acceptable time with high success.