This investigation was presented at the 2008 Annual Meeting of the American Society of Anesthesiologists, Orlando, FL, USA.
Evaluation of the Pentax-AWS® and the Macintosh laryngoscope in difficult intubation: a manikin study
Article first published online: 13 JAN 2011
© 2011 The Authors. Journal compilation © 2011 The Acta Anaesthesiologica Scandinavica Foundation
Acta Anaesthesiologica Scandinavica
Volume 55, Issue 2, pages 223–227, February 2011
How to Cite
KARIYA, T., INAGAWA, G., NAKAMURA, K., FUJIMOTO, J., AOI, Y., MORITA, S. and GOTO, T. (2011), Evaluation of the Pentax-AWS® and the Macintosh laryngoscope in difficult intubation: a manikin study. Acta Anaesthesiologica Scandinavica, 55: 223–227. doi: 10.1111/j.1399-6576.2010.02363.x
- Issue published online: 13 JAN 2011
- Article first published online: 13 JAN 2011
- Accepted for publication 29 October 2010
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.