Comparison of the Airtraq to the Bonfils Fibroscope for Endotracheal Intubation in a Simulated Difficult Airway

Background: Difficult intubation, represent a challenge to anesthetist especially that many cases are encountered after induction of anesthesia. The Airtraq and the Bonfils fibroscopes are new devices designed to facilitate intubation under normal and difficult circumstances. In the present study, the efficacy and the intubation success rate of the Airtraq to the Bonfils fiberscope were evaluated in patients wearing a rigid cervical collar to simulate difficult airway. Methods: Sixty patients ASA I and II requiring intubation as part of anesthesia were enrolled in the study. Patients were randomly assigned according to the device used during intubation to the Airtraq group (n=30) or the Bonfils group (n=30). After administration of IV anesthetics and before intubation, the neck was stabilized with rigid neck collar. Overall intubation success rate, time required for intubation, the number of attempts required for successful intubation, visual analogue scale (VAS, 0-10) for easiness of use of both devices and airway complications related to intubation were recorded. Postoperative sore throat and hoarsness were also evaluated using numerical scale (0-10). Results: The overall success of intubation was 93.3% for the Airtraq and 90% for the Bonfils, p>0.05. Time to successful intubation was significantly shorter for the Airtraq 40 ±8 seconds compared to the Bonfils group 48 ± 10 seconds, p<0.05. The number of required intubation attempts, were comparable between the two groups. One attempt was required in 20 patients (66.6%) versus 19 patients (63.3%) and two attempts were required in 7 patients (23.3%) versus 6 patients (20%) while three attempts were required in 1 patient (3.3%) versus 2 patients (6.6%) in Airtaq group and Bonfils group respectively, p>0.05. The incidence of intubation complication was comparable between the groups. Visual analogue scale for easiness of use of both devices and numerical scale for postoperative sore throat and hoa rsness were comparable between the two groups. Conclusion: Both the Airtraq and the Bonfils fiberscope offer high success rate in patients with predicted difficult airway.