The performance of rigid scopes for tracheal intubation: a randomised, controlled trial in patients with a simulated difficult airway

Kleine-Brüggeney, Maren; Greif, Robert; Urwyler, Natalie Sandra; Wirthmüller, Beat; Theiler, Lorenz (2016). The performance of rigid scopes for tracheal intubation: a randomised, controlled trial in patients with a simulated difficult airway. Anaesthesia, 71(12), pp. 1456-1463. Wiley-Blackwell 10.1111/anae.13626

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We compared the Bonfils(™) and SensaScope(™) rigid fibreoptic scopes in 200 patients with a simulated difficult airway randomised to one of the two devices. A cervical collar inhibited neck movement and reduced mouth opening to a mean (SD) of 23 (3) mm. The primary outcome parameter was overall success of tracheal intubation; secondary outcomes included first-attempt success, intubation times, difficulty of intubation, fibreoptic view and side-effects. The mean (95% CI) overall success rate was 88 (80-94)% for the Bonfils and 89 (81-94)% for the SensaScope (p = 0.83). First-attempt intubation success rates were 63 (53-72)% for the Bonfils and 72 (62-81)% for the SensaScope (p = 0.17). Median (IQR [range]) intubation time was significantly shorter with the SensaScope (34 (20-84 [5-240]) s vs. 45 (25-134 [12-230]) s), and fibreoptic view was significantly better with the SensaScope (full view of the glottis in 79% with the SensaScope vs. 61% with the Bonfils). This might be explained by its steerable tip and the S-formed shape, contributing to better manoeuvrability. There were no differences in the difficulty of intubation or side-effects.

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