Flexible optical intubation via the Ambu Aura-i vs blind intubation via the single-use LMA Fastrach: a prospective randomized clinical trial

•Blind intubation via the LMA Fastrach was faster than flexible scope intubation via the Ambu Aura-i.•There was no difference in intubation success rate between the 2 techniques.•No difference in the incidence of airway morbidity was seen in the 2 groups.

Study ObjectiveThis study was designed to compare the Ambu Aura-i to the single-use LMA Fastrach regarding time to intubation, success rate, and airway morbidity in patients undergoing elective surgery requiring general anesthesia.DesignProspective, randomized controlled trial.SettingAcademic medical center.PatientsSixty-five adult patients scheduled for elective surgery requiring general anesthesia.InterventionsPatients were randomized into 2 groups. Group A (n = 33) were intubated using Ambu Aura-i and the Ambu aScope 2, a disposable flexible intubating scope, whereas those in group B (n = 33) were blindly intubated using the Intubating Laryngeal Mask Airway (ILMA).MeasurementsFirst-attempt intubation success rate, overall intubation success rate, time to intubation, incidence of airway morbidity.Main resultsThe data demonstrated that time for endotracheal intubation in the ILMA group was significantly shorter than in the Ambu Aura-i group (P < .05). There was no difference in the first-attempt intubation success rate (Aura-i = 26/33, 78.8%; ILMA = 27/33, 81.8%; P = .757) or the overall intubation success rate (Aura-i = 29/33, 87.9%; ILMA = 31/33, 93.9%; P = .392) between the groups. Four patients (12%) in the Ambu Aura-i group had a failed intubation; 1 was due to a failure of the aScope monitor, whereas 3 were due to inability to visualize the glottis. Two patients (7%) in the ILMA group had a failed intubation due to esophageal intubation. There was no statistically significant difference in airway morbidity between the 2 groups.ConclusionsThe data suggest that intubation with the ILMA is faster but that first-attempt and overall intubation success rates were comparable in both groups. The results suggest that although the flexible intubating scope–guided Aura-i does not outperform blind intubation via the ILMA, the technique is comparable in terms of first-attempt and overall intubation success rate.