[Use of the Airway Scope for awake intubation in five cases]

Several case reports have shown that the Airway Scope is useful in patients with difficult airways. We experienced five patients with known or predicted difficult airways who underwent awake intubation using the Airway Scope. The patients were known or predicted as having a difficult airway due to the following factors: limited head and neck movement (2 cases), risk for aspiration of gastric contents (1 case), and the thyroid tumor causing displacement of the trachea (2 cases). After the desired sedation with fentanyl and topical anesthesia of the airway, awake intubation was performed using the Airway Scope. All patients were successfully intubated without any complications. This experience suggests that the technique has the following advantages. First, the Airway Scope allows detection of regurgitation and vomiting during intubation and avoids accidental esophageal intubation. Second, the Airway Scope provides a useful means of teaching and supervising tracheal intubation compared with the conventional Macintosh laryngoscope. We believe that this method can achieve effective, safe and successful awake intubation in patients with known or predicted difficult airways.