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Volume 4 (January 2006 to December 2007)


 

The Airtraq Optical Laryngoscope Specifically Designed for Nasotracheal Intubation

 

 

Ernst Zadrobilek, MD1

 

1Associate Professor of Anesthesia and Intensive Care, Chairman of the Austrian Working Group for Airway Management and Director of the Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of Vienna, Vienna, Austria.

 

Address correspondence and comments to Ernst Zadrobilek.

 

Received from the Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of Vienna, Vienna, Austria.

 

Published: December 1, 2007.

 


 

The correct citation of this communiction of new equipment and techniques is:

Zadrobilek E. The Airtraq Optical Laryngoscope specifically designed for nasotracheal intubation. Internet Journal of Airway Management 4, 2006-2007.
Available from URL:
http://www.adair.at/ijam/volume04/newequipment05/default.htm
Date accessed: month day, year.

 


Last updated: July 1, 2008.


 

The battery-powered, portable Airtraq Optical Laryngoscope (AOL; manufactured by Prodol Meditec, Vizcaya, Spain) is a new disposable device (with an anatomically shaped blade) developed to facilitate orotracheal intubation in patients with normal and difficult airways. The AOL allows for the transmission of a color image to the view finder at the proximal end of the laryngoscope handle (by internal arrangements of optical components), usually providing the operator a panoramic view of the laryngeal aperture when properly inserted (1-3). We recently evaluated the AOL in formally instructed but novice users and determined that the success of tracheal intubation with this device was not affected by conventional laryngoscopic view grading (3).

 

The manufacturer recently released a modified AOL specifically designed for nasotracheal intubation. This AOL is currently available in one size (orange-coded, maximum thickness of the blade: 18 mm). The tube-guide channel at the right side of the original AOL [to guide standard tracheal tubes (TTs) into the correct position] was removed; the remaining flange of the blade serves now as guidance for the nasally introduced TT.

 

Nasotracheal intubation is simple [evaluated on a suitable airway model (AirSim Multi, TruCorp, Belfast, United Kingdom)] as with orotracheal intubation using the original AOL. The modified AOL is first inserted in the midline just into the oral cavity; when the TT is in view at the right side of the blade flange, the blade is then further slided around the tongue into the posterior pharynx. The tip of the blade is placed posterior and slightly distal to the posterior surface of the epiglottis (Miller-laryngoscopy technique), followed by a slightly vertical-directed lifting force to directly elevate the epiglottis and expose the laryngeal aperture (Pedro A. Gandarias, personal communication). When the laryngeal aperture is in the center of the view finder, the TT may be easily passsed along the flange of the blade through the laryngeal aperture into a midtracheal position. Unfortunately, there are currently no studies available to support these experiences in clinical practice.

 

The costs of the modified AOL for nasotracheal intubation are about 48 Euro (exclusive value-added taxes, according to the offer of the Austrian distributor, queried in July 2008).

 

 

References

  1. Maharaj CH, Buckley E, Harte BH, Laffey JG. Endotracheal intubation in patients with cervical spine immobilization. A comparison of Macintosh and Airtraq laryngoscopes. Anesthesiology 107:53-59, 2007.

  2. Maharaj CH, O'Croinin D, Curley G, Harte BH, Laffey JG. A comparison of tracheal intubation using the AirtraqR or the Macintosh laryngoscope in routine airway management: a randomised, controlled clinical trial. Anaesthesia 61:1093-1099, 2006.

  3. Missaghi MS, Krasser K, Lackner-Ausserhofer H, Moser A, Zadrobilek E. The Airtraq Optical Laryngoscope: experiences with a new disposable device for orotracheal intubation. Internet Journal of Airway Management 4, 2006-2007. Date accessed: July 1, 2008.


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