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Abstract
The major responsibility of the anaesthetist towards the patient is the provision for adequate respiration. The most vital element in providing functional respiration is the airway; so no anaesthesia is safe unless adequate efforts are devoted to maintain an intact, patent and functional airway(1) The placement of an endotracheal tube is frequently necessary for maintaining an intact airway in patients who require mechanical ventilation in most of the patients requiring general anaesthesia in the operating room and in the pre-hospital setting, emergency room and intensive care unit.
While direct vision laryngoscopy has been proved over the years to be reliable and relatively easy, the accurate and prompt placement of the endotracheal tube remains a major challenge for some patients even in the hands of the experienced anesthetists. (2) It has been estimated that between 1-3% of patients have difficult airways and may encounter difficulties in the endotracheal intubation using rigid laryngoscope blades. This technique is inexpensive but its major disadvantage is the inability to mold the blade to fit individual variations in patient’s airway anatomy and the possibility of soft tissue and dental injuries.
Many other alternative techniques have been described for endotracheal intubation including intubation with the assistance of ’’ Intubating Laryngeal mask airway ’’ and the ’’ Optical Laryngoscope ’’’ (Airtraq).
The LMA Fastrach (intubating LMA, ILMA) was designed to obviate the problems encountered when attempting to blindly intubate the trachea through a classic LMA.
Optical Laryngoscope ’’Airtraq’’ (Prodol Meditec S.A., Vizcaya, Spain) is the industry’s first disposable optical laryngoscope which is a new visual guiding system for routine and complex airway use. The affordable high definition optical system provides a magnified view during laryngoscopic procedures. Simple to set up and simple to use, the airtraq has a built-in anti-fog system and a light source. Available in small and regular sizes, the airtraq accommodates standard endotracheal tubes and can be enhanced with a small, reusable clip-on video system to allow viewing on an external monitor. (8)
Aim of the work to determine easiness, effectiveness and safety of tracheal intubation using optical laryngoscopy ’’airtraq’’ compared with conventional laryngoscopy and LMA Fastrach in patients at risk for difficult tracheal intubation scheduled for elective surgical patients, to determine the immediate and late complications of the optical laryngoscopy ’’airtraq’’ technique compared with conventional laryngoscopy and LMA Fastrach technique for endotracheal intubation and to determine haemodynamic effect of airtraq technique with conventional laryngoscopy and LMA Fastrach for endotracheal intubation.