[Comparison of Seven Intubation Devices in Difficult Airway Model]

The efficacy in tracheal intubation may differ between different video-optical devices, in particular in patients with difficult airways. The purpose of this study was to evaluate the efficacy of video-laryngoscopes and fiberoptic bronchoscope (FOB) in tracheal intubation on a mannequin with several difficult airways, including limited mouth opening, cervical spine rigidity and tongue edema.

Residents performed tracheal intubation on a mannequin using Macintosh laryngoscope (Mac), rigid indirect-optical intubation devices and FOB. The laryngeal view, the success rate of tracheal intubation, and the time to intubate trachea were recorded.

With limited mouth opening and cervical spine rigidity, video-optical intubation devices showed a significantly higher success rate of tracheal intubation than the Mac or FOB. In contrast, with tongue edema, the success rate of tracheal intubation was lower when Mac-type videolaryngoscopes were used.

Videolaryngoscopes can generally be useful in patients with all difficult airways, but may be difficult in some circumstances (such as tongue edema). The FOB provided good laryngeal view in all cases, but the success rate of tracheal intubation was low and the time to intubate trachea was long.