Comparative evaluation of intubating laryngeal mask airway with fiberoptic bronchoscopic intubation in anticipated difficult airway: A randomized controlled study

Abstract

Background: Management of difficult airway remains a cornerstone of anesthesiology requiring constant probe into newer devices challenging set gold standards. Hence, we compared the effectiveness of intubating laryngeal mask airway (ILMA) with flexible fiberoptic bronchoscope (FOB) in anticipated difficult airway. Aims: The aim of this study was to compare and evaluate ILMA and FOB for tracheal intubation in patients with anticipated difficult airway. Settings and Design: The study design involves comparative randomized study. Materials and Methods: Fifty patients undergoing elective surgery under general anesthesia with anticipated difficult airway (Modified Mallampati Class III/Wilson's Score 6-7) were divided into Group I (ILMA) and Group F (FOB). Primary outcomes, i.e., ease of intubation (number and duration of attempts) and success rate; and secondary outcomes, i.e., hemodynamic parameters and adverse events were noted. Results: Both the groups were comparable in age, gender distribution, body mass index, and type of surgery. The number of attempts required and hemodynamics changes were similar in both groups. ILMA required lesser time, i.e., 59.76 s versus FOB, i.e., 109.88 s in the first attempt (DA1) and 62.67 s for Group I versus 120.86 s for Group F in the second attempt (DA2), being statistically significant. ILMA showed higher adverse event rate versus FOB; however, the difference was statistically insignificant. Conclusions: ILMA is an effective alternative to FOB in patients with anticipated difficult airway with respect to ease of intubation, with similar hemodynamic stability, success rate, and adverse events. Anticipated difficult airway, fiberoptic bronchoscope, intubating laryngeal mask airway