Tracheal intubation via the Classic™ and Proseal™ laryngeal mask airways: a manikin study using the Aintree Intubating Catheter

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Abstract
Summary: Fibreoptic‐assisted tracheal intubation with an Aintree Intubating Catheter via a dedicated airway is sometimes recommended when conventional tracheal intubation fails. This study compares the use of the Classic™ and Proseal™ laryngeal mask airways (LMA) for this purpose in a manikin. Twenty‐five anaesthetists of all grades performed two intubations with each device. The overall success rate was 95%. The procedure took < 90 s in all cases and < 60 s in 88% of patients. The speed of intubation increased from the first to fourth attempt and between the first and second attempt with each device (p < 0.001). Allowing for the learning effects observed with each device, there was no statistically significant difference found when comparing speed of intubation with the two devices (p > 0.05). There was no significant difference between the devices with regard to ease of advancement of the fibrescope or the view of the vocal cords with the Aintree Intubating Catheter. Four failures occurred with the LMA Classic and one with the LMA Proseal. Subjective comments favoured the LMA Proseal (p < 0.05), although the clinical importance of these comments is difficult to determine. This study has shown that, in a manikin, fibreoptic guided intubation via an LMA Proseal is at least as easy and reliable as through an LMA Classic. In view of the potential advantages of the LMA Proseal for airway rescue and management of the difficult airway, this study suggests a clinical evaluation of the use of the combination of an LMA Proseal and an Aintree Intubating Catheter in patients is justified.