Fiberoptic-guided tracheal tube placement through the air-Q® Intubating Laryngeal Airway: a performance study in a manikin.

PURPOSE: This study characterizes the performance and success rate for fiberoptic-guided tracheal tube placement through the air-Q(®) Intubating Laryngeal Airway (air-Q).

METHODS: Using a manikin, anesthesia trainees and staff anesthesiologists, experienced in fiberoptic-guided intubation, performed five consecutive fiberoptic-guided tracheal tube placements via the air-Q. Participant characteristics, procedure segment times, total procedure times, and observed failures were recorded. Linear mixed effect models with random slopes and intercepts were used to assess participant performance.

RESULTS: Ten anesthesia trainees and ten staff anesthesiologists participated. Anesthesia trainees were younger and had practiced for fewer years compared to staff anesthesiologists. Gender was equally distributed between the groups. Both segmental and overall procedure times decreased from the first to the fifth trial among all participants, independent of experience level and gender. Overall mean procedure time decreased from 102 ± 31 to 68 ± 14 s, representing a relative time reduction of 33% and a mean time difference of 34 s [95% confidence interval (CI) 22-47 s; p < 0.0001]. Tracheal tube placement was successful in all attempts; however, three tracheal tube dislodgements occurred during air-Q removal (overall procedure success 97%).

CONCLUSIONS: Fiberoptic-guided tracheal tube placement through the air-Q can be performed in a clinically acceptable period of time with high success by operators skilled in fiberoptic-guided intubation. Tracheal tube dislodgement during air-Q removal remains a potential risk that should be emphasized.