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      Blind Tracheal Intubation through the Air-Q Intubating Laryngeal Airway in Pediatric Patients: Reevaluation – A Randomized Controlled Trial

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          Abstract

          Context:

          Some pediatric supraglottic airway devices have not been evaluated in a large perspective for blind intubation although they are validated as a conduit for fiberoptic-guided intubation.

          Objective:

          The objective of this study was to compare the success rate of blind technique with correction maneuvers versus fiberoptic-guided intubation through the air-Q laryngeal airway in pediatric patients.

          Patients and Methods:

          One hundred and twenty-six pediatric patients undergoing elective surgery under general anesthesia were randomized into two equal groups. The air-Q was placed in all patients as a conduit for tracheal intubation. Group B patients underwent blind intubation with correction maneuvers. Group F patients underwent fiberoptic-guided intubation.

          Results:

          There was no significant difference between the groups regarding the success rate of intubation or postextubation complications. Group F patients showed a significantly longer time to intubation and total time of the trial. Furthermore, Group F patients showed a significantly higher level of pre- and postintubation heart rate compared to Group B patients.

          Conclusion:

          Blind tracheal intubation in pediatric patients through the air-Q with correction maneuvers could be a good alternative for fiberoptic-guided intubation with stable hemodynamics and shorter time till intubation.

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          Most cited references 17

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          Difficult Airway Society guidelines for management of the unanticipated difficult intubation.

           M Popat,  ,  I Latto (2004)
          Problems with tracheal intubation are infrequent but are the most common cause of anaesthetic death or brain damage. The clinical situation is not always managed well. The Difficult Airway Society (DAS) has developed guidelines for management of the unanticipated difficult tracheal intubation in the non-obstetric adult patient without upper airway obstruction. These guidelines have been developed by consensus and are based on evidence and experience. We have produced flow-charts for three scenarios: routine induction; rapid sequence induction; and failed intubation, increasing hypoxaemia and difficult ventilation in the paralysed, anaesthetised patient. The flow-charts are simple, clear and definitive. They can be fully implemented only when the necessary equipment and training are available. The guidelines received overwhelming support from the membership of the DAS. It is not intended that these guidelines should constitute a minimum standard of practice, nor are they to be regarded as a substitute for good clinical judgement.
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            A randomized trial comparing the Ambu ® Aura-i ™ with the air-Q ™ intubating laryngeal airway as conduits for tracheal intubation in children.

            To assess the clinical performance of the Ambu Aura-i (Aura-i) in children.
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              The new air-Q intubating laryngeal airway for tracheal intubation in children with anticipated difficult airway: a case series.

              The air-Q intubating laryngeal airway (ILA) is a new supraglottic airway device which may overcome some limitations inherent to the classic laryngeal mask airway for tracheal intubation. We present a case series of patients with anticipated difficult airway in whom the air-Q ILA was successfully used as a conduit for fiberoptic intubation.
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                Author and article information

                Journal
                Anesth Essays Res
                Anesth Essays Res
                AER
                Anesthesia, Essays and Researches
                Wolters Kluwer - Medknow (India )
                0259-1162
                2229-7685
                Apr-Jun 2019
                : 13
                : 2
                : 269-273
                Affiliations
                Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt
                Author notes
                Address for correspondence: Dr. Enas A. Abd El motlb, Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt. E-mail: sevo2006@ 123456gmail.com
                Article
                AER-13-269
                10.4103/aer.AER_42_19
                6545951
                Copyright: © 2019 Anesthesia: Essays and Researches

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

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