comparison of ease and time taken for tracheal intubation through the intubating laryngeal mask airway with the air-q in adults. A one year hospital based randomized control study

Abstract

Introduction:Laryngeal mask airway (LMA) has been the cornerstone in the management of difficult airway . Though Intubating LMA (ILMA) as a conduit for tracheal intubation has been the standard device, identification of other alternate reliable devices would aid in choosing the ideal device for intubation. Hence, an attempt is being made to assess the performance of Air-Q compared to ILMA with regards to ease and time taken for intubation insertion through the LMAs , aswell as the ease and duration of insertion of the airway devices. Methodology: The present randomized clinical trial was conducted on 60 ASA I and II patients aged weighing 50 to 100 Kgs posted for elective surgeries under general anaesthesia in KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. Patients were allocated into two equal groups, Group A- ILMA (n=30) and Group B - Air-Q (n=30). All the data collected were analysed. Comparisons between continuous variables of two groups were done by unpaired Student’s t-test .Comparing categorical variables were done by chi-square -test. All p-values were considered significant when p-values less than 0.05. Results:Insertion was easy for significantly more patients in Air-Q group (27/30,90%) compared to ILMA group (16/30, 53.3%) . With regards to intubation, our study proved intubation to be easy in little more than two third of ILMA group patients (22/30,73.33%). Moderate difficulty in insertion was seen only in 8 patients in ILMA group (26.67%). All 30 patients in group Air-Q (100%) showed moderate difficulty for intubation. This difference was found to be statistically significant. (p<.0001). The mean duration of intubation was 37.13 +0.48 sec in ILMA group and higher (47.73+4 sec) in Air Q group. This difference was found to be statistically significant (p=0.0001),while the mean duration of insertion of the device was significantly (P<.0001) longer in ILMA group in our study ,compared to Air-Q group (19.6 s vs 11.9 s) .Visible blood on the device was noted in 6 patients in the ILMA group and 1 patient in Air-Q group which was statistically insignificant. No bronchospasm and laryngospam were noted in patients of either group. Conclusion: In our study, the Air-Q was easier to insert than the ILMA in anaesthetized paralysed adult patients, but it took a statistically significant longer time to intubate through the Air-Q when compared with the ILMA.