Tracheal intubation by non-anesthesia residents using the Pentax-AWS airway scope and Macintosh laryngoscope.

STUDY OBJECTIVE: To evaluate the performance of the Pentax-AWS airway scope for tracheal intubation compared with the Macintosh laryngoscope by non-anesthesia residents.

DESIGN: Prospective, randomized, cohort study.

SETTING: University-affiliated hospital.

PATIENTS: 520 patients who underwent tracheal intubation for general anesthesia.

INTERVENTIONS: 48 non-anesthesia residents performed tracheal intubation using either the Pentax-AWS or the Macintosh laryngoscope.

MEASUREMENTS: Time to complete tracheal intubation, number of attempts until successful intubation, and number of intubations of the esophagus were recorded.

RESULTS: Time to secure the airway (sec; mean +/- SD) was shorter with the Pentax-AWS than with the Macintosh laryngoscope (44 +/- 19 vs. 71 +/- 44 sec; P < 0.001). Of the 264 tracheal intubations with the Pentax-AWS, 239 (91%) were completed within 60 seconds, while only 148 (58%) of the 256 tracheal intubations performed with the Macintosh laryngoscope were completed within the same period. The rate of successful intubations on the first attempt was higher with the Pentax-AWS than the Macintosh laryngoscope (P < 0.001). No esophageal intubation was experienced with the Pentax-AWS approach, while 18 occurred with the Macintosh laryngoscope (P < 0.001).

CONCLUSION: The Pentax-AWS appears to require less operator skill than the Macintosh laryngoscope. Use of the Pentax-AWS may reduce the time to secure the airway and the incidence of failed tracheal intubation by non-anesthesia residents.