Performance of the Airtraq laryngoscope after failed conventional tracheal intubation: a case series.

BACKGROUND: The Airtraq, a new disposable indirect laryngoscope, was evaluated in patients with difficult intubation.

METHODS: The Airtraq was used in 47 patients with predicted or unpredicted difficult intubation after failed orotracheal intubation performed by two senior anaesthesiologists with the Macintosh laryngoscope.

RESULTS: Tracheal intubation with Airtraq was successful in 36 patients (80%). The Cormack and Lehane score was IIb-III in 35 patients, and IV in 12 patients, with the Macintosh laryngoscope, while Cormack and Lehane score was I-IIa in 40 patients, IIb-III in three and IV in four with Airtraq. A gum elastic bougie was used to facilitate tracheal access in one-third (11/36) of the cases. Orotracheal intubation was not possible with Airtraq in nine cases, five of whom had a pharyngeal, laryngeal or basal lingual tumour.

CONCLUSION: In patients with difficult airway, following failed conventional orotracheal intubation, Airtraq allows securing the airway in 80% of cases mainly by improving glottis view. However, the Airtraq does not guarantee successful intubation in all instances, especially in case of laryngeal and/or pharyngeal obstruction.