Comparison of the single-use Ambu(®) aScope™ 2 vs the conventional fibrescope for tracheal intubation in patients with cervical spine immobilisation by a semirigid collar*

Anaesthesia. 2013 Jan;68(1):21-6. doi: 10.1111/anae.12044. Epub 2012 Oct 22.

Abstract

Fibreoptic intubation remains a key technique for the management of difficult intubation. We randomly compared the second generation single-use Ambu(®) aScope™ 2 videoscope with a standard re-usable flexible intubating fibrescope in 50 tracheal intubations in patients with a difficult airway simulated by a semirigid collar. All patients' tracheas were intubated successfully with the aScope 2 or the re-usable fibrescope. The median (IQR [range]) time to intubate was significantly longer with the aScope 2 70 (55-97 [41?-226]) s vs 50 (40-59 [27-175]) s, p = 0.0003) due to an increased time to see the carina. Quality of vision was significantly lower with the aScope 2 (excellent 24 (48%) vs 49 (98%), p = 0.0001; good 22 (44%) vs 1 (2%), p = 0.0001; poor 4 (8%) vs 0, p = 0.12) but with no difference in the subjective ease to intubate (easy score of 31 (62%) vs 38 (76%), p = 0.19; intermediate 12 (24%) vs 7 (14%), p = 0.31; difficult 7 (14%) vs 5 (5%), p = 0.76). The longer times to intubate and the poorer scores for quality of vision do not support the use of the single-use aScope 2 videoscope as an alternative to the re-usable fibrescope.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthesia, General
  • Bronchoscopes
  • Bronchoscopy
  • Cervical Vertebrae / anatomy & histology*
  • Disposable Equipment
  • Endpoint Determination
  • Equipment Reuse
  • Female
  • Fiber Optic Technology
  • Follow-Up Studies
  • Humans
  • Immobilization / methods*
  • Intubation, Intratracheal / instrumentation*
  • Intubation, Intratracheal / methods
  • Male
  • Neck / anatomy & histology
  • Respiration, Artificial
  • Sample Size
  • Treatment Outcome