Document Detail

Evaluation of the Pentax-AWS(®) and the Macintosh laryngoscope in difficult intubation: a manikin study.
MedLine Citation:
PMID:  21226865     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The Pentax-AWS (AWS(®)), a new video laryngoscope, has been shown to be useful in cases of difficult intubation. We hypothesized that the AWS(®) would be more useful in the settings of a narrow upper airway than the Macintosh laryngoscope. We compared each device in simulated scenarios of representative difficulty of tracheal intubation using a manikin. The primary endpoint was the rate of successful intubation.
METHODS: With each device, 23 anesthesiologists performed tracheal intubation in a SimMan(®) manikin in the following scenarios: (1) normal airway, (2) tongue edema, (3) cervical spine rigidity, (4) pharyngeal obstruction, (5) jaw trismus, (6) tongue edema with pharyngeal obstruction. The intubation time and success rate were measured. Each participant was asked to rate the difficulty of intubation (1=very easy; 5=very difficult).
RESULTS: In the scenarios of tongue edema and tongue edema with pharyngeal obstruction, the AWS(®) yielded a higher success rate (100% vs. 34.8%; P<0.001, 65.2% vs. 21.7%; P=0.006), a shorter intubation time [14.6 (7.0) vs. 33.4 (13.0) s; P<0.001, 24.5 (12.0) vs. 37.6 (11.9); P=0.047; mean (standard deviation)], and a lower difficulty score [2 (1-4) vs. 5 (1-5); P<0.001, 4 (2-5) vs. 5 (3-5); P<0.001; median (range)], compared with the Macintosh laryngoscope.
CONCLUSION: The AWS(®) has an advantage over the Macintosh laryngoscope in simulated tongue edema and tongue edema with pharyngeal obstruction. Further studies in a clinical setting are necessary to confirm these findings.
T Kariya; G Inagawa; K Nakamura; J Fujimoto; Y Aoi; S Morita; T Goto
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  55     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-13     Completed Date:  2011-04-25     Revised Date:  2011-08-26    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  223-7     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Journal compilation © 2011 The Acta Anaesthesiologica Scandinavica Foundation.
Department of Anesthesiology and Critical Care Medicine, Yokohama City University School of Medicine, Japan.
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MeSH Terms
Airway Obstruction
Clinical Competence
Edema / complications
Endpoint Determination
Intubation, Intratracheal / instrumentation*
Pharynx / pathology
Sample Size
Spinal Diseases / pathology
Tongue / pathology
Trismus / pathology
Comment In:
Acta Anaesthesiol Scand. 2011 Aug;55(7):900-1; author reply 901   [PMID:  21615339 ]

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