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• W3033018940 abstract "Background: Fibreoptic intubation via a supraglottic device (SAD) is ‘low skill fibreoptic intubation’ (LSFOI). ‘Standard’ second generation SADs (i-gel TM ) have a gastric port. ‘Specialised’ second generation SADs (air-Q TM ) are designed to facilitate LSFOI and have wider ventilation ports. Our hypothesis was that performance of LSFOI differs between i-gel TM and air-Q TM in a manikin with a simulated difficult airway. Methods: Our primary outcome was fibreoptic intubation success rate. Our secondary outcomes included SAD insertion and LSFOI times. A difficult airway was simulated by applying a hard cervical collar to a manikin. Anaesthetists performed LSFOI serially using both SADs in a random sequence. In the manikin study, 80 anaesthetists were recruited. To test the robustness of the conclusion from our manikin study, we repeated the study in 22 anaesthetised patients. Patients were fitted with the same cervical collar and randomly allocated to either devices. We used McNemar’s statistical test to analyse our primary outcome of successful intubations and paired nominal data. A Wilcoxon signed-ranks test was used to analyse nonparametric paired data and a Mann–Whitney U test was used for unpaired data analysis where appropriate. A p-value of <0.05 was considered statistically significant. Results: In the manikin study, the i-gel TM was superior to the air-Q TM for successful tracheal intubation (98.8% vs 83.8%, respectively; p=0.002) and LSFOI times (34.0 s vs 36.0 s, respectively; p=0.012). In the patient study, LSFOI success rates were not significantly different between i-gel TM and air-Q TM (100% vs 91.6%, respectively; p=0.545) but intubation times were shorter (52.5 s vs 60.0 s, respectively; p=0.036). Conclusion: In conclusion, we obtained LSFOI success rates for the i-gel TM or air-Q TM of 98.8% and 83.8% respectively in a manikin; and 100% and 91.6% respectively in patients. It is in fact ‘low skill’ as many participants were successful despite no prior experience with LSFOI. The i-gel TM is superior for LSFOI compared with the air-Q TM . This is despite being a ‘standard’ second generation SAD as compared to a ‘specialised’ second generation SAD (air-Q TM ). Trial Registration: The manikin and patient studies were conducted after being approved by the SingHealth Centralised Institutional Review Board (CRB reference number 2014/2039 and 2016/2069, respectively). The patient study was registered at ClinicalTrials.gov (ID: NCT02663843)." @default.
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• W3033018940 date "2020-06-02" @default.
• W3033018940 modified "2023-09-27" @default.
• W3033018940 title "Low skill fibreoptic intubation using i-gel™ and air-Q™ in simulated difficult airways: A randomised study in manikin and in patients" @default.
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• W3033018940 doi "https://doi.org/10.1177/2010105820929049" @default.
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