Search

Background: It can be difficult for anesthesiologists to manage the airway of morbidly obese patients. Devices like the intubating laryngeal mask airway (ILMA) -FastTrach™) and Air-Q™ were specially designed to make tracheal intubation easier while ensuring ventilation and oxygenation. This study compared the efficiency of these two supraglottic airway devices (SAD) for fiberoptic intubation in adult morbidly obese patients. Methods: Eighty morbidly obese (BMI>40 kg/m2) patients planned for elective surgery requiring tracheal intubation and general anesthesia participated in the study. Patients were allocated to the ILMA group or the Air-Q group. A fiberoptic bronchoscope was used to intubate the trachea through the SAD. The primary endpoint was the time to intubate the trachea. The time to insert the SAD, the insertion success rate of the SAD and tracheal tube, the laryngeal view, and any adverse events related to the procedure, were the secondary outcomes. Results: The mean tracheal intubation time was shorter through the Air-Q™ compared to the ILMA-Fastrach™ (41.4 ±6.1 s vs 76.22 ±10.2 s, P< 0.001). The mean insertion time of the Air-QTM was significantly shorter than that of the ILMAFastrachTM (18.9 ±0.7 s vs 25.1 ±1.3 s, P < 0.001), The Air-Q had a significantly better success rate for tracheal tube insertion on the first attempt, but the overall intubation success rate was comparable for both devices. Conclusion: Air-Q™ was associated with a shorter time of device insertion and fiberoptic intubation, and a higher first-attempt insertion success rate of the tracheal tube than ILMA-FastrachTM. [ABSTRACT FROM AUTHOR]

Abstract Background: Obesity causes various difficulties in intubation and ventilation, which are confronted due to increased fat tissue in the upper airway and diminished compliance in the chest wall. Videolaryngoscopes and Intubating Laryngeal Mask Airway (ILMA) are good options as recommended by the American Society of Anesthesologists (ASA) difficult airway guidelines. We aimed to compare ILMA and Airtraq (a channeled videolaryngoscope) in obese patients. Methods: Eighty patients with ASA physical status 1-3, aged between 18 and 65 years and with a body mass index greater than 35 kg.m-2, who were undergoing elective surgery requiring orotracheal intubation, were included in the study. Patients were intubated with one of the devices cited. Results: There was no difference between the number of intubation attempts, insertion times and need for optimisation manoeuvres of Airtraq and ILMA. The intubation with Airtraq was accomplished in a shorter period of time than in that in the ILMA group (29.9 ± 22.1s vs. 50.7 ± 21.2s; p < 0.001). A significant difference was found when the times of total intubation were compared (29.9 ± 22.1s vs. 97.4 ± 42.7s; p < 0.001). The mean arterial pressure statistically increased after device insertion in the ILMA group (p < 0.05). Conclusions: Airtraq appears to be superior to ILMA in obese patients, with a total of time intubation of less than 60 seconds and with low mean arterial pressure changes. However, ILMA is still a useful tool that provides both ventilation and intubation throughout the whole intubation process.

Background: Laryngoscopy followed by tracheal intubation is the commonest technique of securing airway. However, laryngoscopy time more than 15 seconds leads to exaggerated pressor response. It can also result into a cardiovascular catastrophe in vulnerable elderly patients. Materials and Methods: A prospective and randomised single centre study was conducted upon patients belonging to American Society of Anaesthesiologist (ASA) physical status I and II who were scheduled for elective surgery under general anaesthesia. Sixty (60) patients were randomly allocated to two groups (I & II) of 30 each by sealed envelope technique. In group I, conventional laryngoscopy and intubation was carried out and in group II, intubation was carried out using intubating laryngeal mask airway (ILMA), fastrach. Results: Haemodynamic parameters (heart rate and mean arterial blood pressure) were compared between the two groups. Two tailed independent t test was used for comparison of the parameters. Rise in heart rate (HR) and mean arterial pressure (MAP) was statistically significant at stage-2 in group I (p >0.001). Conclusion: ILMA insertion and intubation using it can be recommended for patients vulnerable to cardiovascular event. [ABSTRACT FROM AUTHOR]

Background: The administration of sedation and neuromuscular blockade to facilitate extraglottic device (EGD) placement is known as rapid sequence airway (RSA). In the emergency department (ED), EGDs are used largely as rescue devices. In select patients, there may be significant advantages to using EGDs over laryngoscopy as the primary airway device in the ED.Objective: Our study sought to describe the practice of RSA in the ED, including rates of successful oxygenation, ventilation, and complications from EGD use.Methods: We identified patients in the ED between 2007 and 2017 who underwent RSA with the LMA® Fastrach™ (hereafter termed ILMA; Teleflex Medical Europe Ltd., Athlone, Ireland) placed as the first definitive airway management device. A trained abstractor performed chart and video review of the cases to determine patient characteristics, physician use of the ILMA, indication for ILMA placement, success of oxygenation and ventilation, success of intubation, and complications related to the device.Results: During the study period, 94 patients underwent RSA with the ILMA. Of those, 93 (99%) were successfully oxygenated and ventilated, and when intubation was attempted, 89% were able to be intubated through the ILMA. The incidence of vomiting and aspiration was 1% and 3%, respectively. There were 30 different attending physicians who supervised RSA and the median number was 2 per physician in the 10-year study period.Conclusion: The practice of RSA with the ILMA in the ED is associated with a high rate of successful oxygenation, ventilation, and intubation with infrequent complications, even when performed by physicians with few experiences in the approach. [ABSTRACT FROM AUTHOR]

Background and Aims: The Ambu® AuraGain• is a new single-use supraglottic airway device with gastric channel, designed to facilitate intubation. The study aimed to assess the success rates of proper placement and intubation using Ambu® AuraGain• compared with intubating laryngeal mask airway (ILMA). Methods: One hundred and twenty patients (18–60 years) were enrolled into this prospective, randomised, comparative study. After inducing general anaesthesia, appropriate size ILMA (group I)/Ambu® AuraGain• (group A) was placed as per the manufacturer's recommendations and correct placement was confirmed. Appropriate size endotracheal tube was passed through the device. The success rate of insertion and intubation, number of attempts, Cormack–Lehane grading before insertion and haemodynamics were recorded. Data were analysed using Mantel–Haenszel Chi-square test, Student's t-test and Fisher's exact test. Results: Demographic and airway parameters were uniformly distributed in both the groups. The success rate for insertion was 100% in both devices. The success rate for intubation was 96.6% (58/60) in group I and 36.6% in group A (P < 0.001). In group I, patients with mean thyromental distance >7.62 ± 0.75 cm had higher successful intubation compared with patients with mean thyromental distance

A obesidade dificulta a ventilação manual e intubação traqueal devido ao acúmulo de tecido adiposo na via aérea superior e a complacência diminuída na caixa torácica. Os videolaringoscópios e as Máscaras Laríngeas para Intubação (MLI) são alternativas boas para o manuseio da via aérea difícil, de acordo com as diretrizes da Sociedade Americana de Anestesologia (ASA). O objetivo do estudo foi comparar o uso da MLI e do Airtraq, um videolaringoscópio com canal, em pacientes obesos. Estudamos 80 pacientes com classificação ASA I‐III, com idades entre 18 e 65 anos e índice de massa corporal acima de 35 kg.m‐2, submetidos a cirurgia eletiva com indicação de intubação orotraqueal. Os pacientes foram intubados empregando‐se um dos seguintes dispositivos: MLI ou Airtraq. Não houve diferença entre o número de tentativas de intubação, tempo de inserção do dispositivo e necessidade de manobras de otimização para o Airtraq e MLI. A intubação com Airtraq foi realizada mais rapidamente do que no Grupo MLI (29,9 ± 22,1 s vs. 50,7 ± 21,2 s; p < 0,001). Houve diferença significante na comparação do tempo total para intubação (29,9 ± 22,1 s vs. 97,4 ± 42,7 s; p < 0,001). Houve aumento estatisticamente significante da pressão arterial média após a inserção do dispositivo no Grupo MLI (p < 0,05). Airtraq parece ser superior a MLI em pacientes obesos, apresentando tempo total de intubação abaixo de 60 segundos e com menor variação na pressão arterial média. Todavia, a MLI ainda é ferramenta útil que propicia tanto ventilação quanto intubação durante todo o processo de manejo da via aérea. Obesity causes various difficulties in intubation and ventilation, which are confronted due to increased fat tissue in the upper airway and diminished compliance in the chest wall. Videolaryngoscopes and Intubating Laryngeal Mask Airway (ILMA) are good options as recommended by the American Society of Anesthesologists (ASA) difficult airway guidelines. We aimed to compare ILMA and Airtraq (a channeled videolaryngoscope) in obese patients. Eighty patients with ASA physical status I‐III, aged between 18 and 65 years and with a body mass index greater than 35 kg.m‐2, who were undergoing elective surgery requiring orotracheal intubation, were included in the study. Patients were intubated with one of the devices cited. There was no difference between the number of intubation attempts, insertion times and need for optimisation manoeuvres of Airtraq and ILMA. The intubation with Airtraq was accomplished in a shorter period of time than in that in the ILMA group (29.9 ± 22.1 s vs. 50.7 ± 21.2 s; p < 0.001). A significant difference was found when the times of total intubation were compared (29.9 ± 22.1 s vs. 97.4 ± 42.7 s; p < 0.001). The mean arterial pressure statistically increased after device insertion in the ILMA group (p < 0.05). Airtraq appears to be superior to ILMA in obese patients, with a total of time intubation of less than 60 seconds and with low mean arterial pressure changes. However, ILMA is still a useful tool that provides both ventilation and intubation throughout the whole intubation process. [ABSTRACT FROM AUTHOR]

Background and Aims: The Ambu® AuraGain• is a new single‑use supraglottic airway device with gastric channel, designed to facilitate intubation. The study aimed to assess the success rates of proper placement and intubation using Ambu® AuraGain• compared with intubating laryngeal mask airway (ILMA). Methods: One hundred and twenty patients (18–60 years) were enrolled into this prospective, randomised, comparative study. After inducing general anaesthesia, appropriate size ILMA (group I)/Ambu® AuraGain• (group A) was placed as per the manufacturer’s recommendations and correct placement was confirmed. Appropriate size endotracheal tube was passed through the device. The success rate of insertion and intubation, number of attempts, Cormack–Lehane grading before insertion and haemodynamics were recorded. Data were analysed using Mantel–Haenszel Chi‑square test, Student’s t‑test and Fisher’s exact test. Results: Demographic and airway parameters were uniformly distributed in both the groups. The success rate for insertion was 100% in both devices. The success rate for intubation was 96.6% (58/60) in group I and 36.6% in group A (P < 0.001). In group I, patients with mean thyromental distance >7.62 ± 0.75 cm had higher successful intubation compared with patients with mean thyromental distance <5.25 ± 0.35 cm (P = 0.014). Cormack–Lehane grading did not correlate with intubation attempts or success rate in group I (P = 0.45), whereas in group A the rate of successful blind intubation with Cormack–Lehane grade 1 was 50% (19/38). Conclusion: Both devices have 100% insertion success, though Ambu® AuraGain• has lower success rate for facilitating intubation compared with ILMA. [ABSTRACT FROM AUTHOR]

Background: The most important duty of an anesthesiologist is to protect the patient's airway and to provide adequate ventilation. The anesthesiologist should be skilled enough to make decisions at the circumstances of difficult intubations. We compared the success rate of blind tracheal intubation through two different supraglottic airway devices, I-GEL and ILMA using PVC endotracheal tube. We studied the complications in both the techniques. The aim of the study: To compare the advanced I-GEL, to ILMA as a conduit for blind endotracheal intubation for patients posted for elective procedures under general anesthesia. Materials and methods: A Prospective randomized study was conducted in 80 adult patients who undergone elective surgery under general anesthesia. They were divided into 2 groups-each group included 40 patients. Group A - I-GEL, Group B-ILMA. We noted the Ease of insertion, Duration of successful attempts, No. of failed attempts, Total intubation time and First attempt success rate. We recorded Heart rate, Blood pressure, Pulse oximetry, EtCO2 and Complications of I-gel and ILMA insertion. Results: Supraglottic device insertion time (15.62s vs 17.17s) and Supraglottic device removal time (15.82s vs 16.55s) were the least I-GEL group. The first attempt success rate for tracheal intubation (87.5% vs 60%) and Success rate for insertion (95% vs 72.5%) were high in the ILMA group. There was no statistical difference in Total intubation time, Complications, Hemodynamic response to intubation, No. of attempts for supraglottic device insertion and Time for first attempt tracheal intubation. Conclusion: We concluded I-GEL aids easy and rapid insertion as a supraglottic airway device, but when it is used as a conduit for blind endotracheal intubation, the failure rate is high as there is more incidence of oesophageal intubation. On the contrary, ILMA being a gold standard device meant for intubation guide has a high first attempt success rate for blind endotracheal intubation. [ABSTRACT FROM AUTHOR]

Background: The intubating laryngeal mask airway (ILMA) allows providers to blindly intubate through the device. We report a case of foreign material obstructing passage of an endotracheal tube (ET) through an ILMA.Case Report: A 45-year-old man with unknown past medical history was found obtunded with an apparent intentional drug and alcohol overdose, and required tracheal intubation. We opted to use an ILMA to optimize preoxygenation prior to intubation. His upper dentures were removed and an ILMA was inserted without complication; ventilation was easily performed. Blind tracheal intubation was attempted; the ET was inserted through the ILMA and was unable to be advanced past 15 cm despite multiple attempts, including repositioning the ILMA and rotating the ET. The ILMA was removed to prepare for video laryngoscopy. He was subsequently successfully intubated using a standard geometry video laryngoscope, which showed no anatomical abnormalities. After the case, the ILMA was inspected and the bowl of the ILMA was found to be occluded with denture adhesive. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report demonstrates that it is possible that foreign material within the ILMA can make successful intubation impossible, despite successful placement and ventilation through the device. Maneuvers may be performed to attempt successful ET intubation, but when unsuccessful, removal of the ILMA and alternate airway management must be performed. [ABSTRACT FROM AUTHOR]

Background: Cervical spine immobilisation with a semi-rigid cervical collar imposes difficulty in tracheal intubation. There is increasing use of the Intubating Laryngeal Mask Airway (LMA- FastrachTM) for intubation in patients with difficult airways. The present study was conducted to assess its potential role for tracheal intubation in simulated fixed cervical spine patients. Method: After obtaining approval from the ethics committee and patients’ consent, this observational study was performed on 35 adult patients of either sex of ASA physical status I and II scheduled to undergo surgery under general anaesthesia requiring tracheal intubation. A two-piece semi-rigid cervical collar of appropriate size was positioned around the neck of patients. A standard anaesthesia protocol comprising glycopyrrolate, propofol and vecuronium was used for induction of anaesthesia. ILMA placement and blind tracheal intubation through this was attempted by using dedicated silicone tube provided with the ILMA set. Success rate, number of attempts required, time taken, difficulties encountered and any complication that occurred were noted. Anaesthesia was maintained with isoflurane in oxygen and nitrous oxide, pethidine and vecuronium. Following completion of surgery, neuromuscular blockade was reversed with glycopyrrolate and neostigmine. Results: The overall success rate was 85.7% and the success rate for ILMA placement at first attempt was 57.1%. Tracheal intubation was successful at first attempt in 70.5% of patients. The time taken for ILMA placement and tracheal intubation through this was 31.76 ± 9.74 and 34.04 ± 12.68 seconds respectively. Decreased mouth opening due to presence of the collar led to difficulty in ILMA placement. Conclusions: Blind tracheal intubation through ILMA is a possible option for airway management in patients with a semi-rigid cervical collar. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To investigate whether nursing staff can successfully use the I-gel and the intubating laryngeal mask Fastrach (ILMA) during cardiopulmonary resuscitation. Background: Although tracheal intubation is considered to be the optimal method for securing the airway during cardiopulmonary resuscitation, laryngoscopy requires a high level of skill. Methods: Forty five nurses inserted the I-gel and the ILMA in a manikin, with continuous and without chest compressions. Results: Mean intubation times for the ILMA and I-gel without chest compressions were 20.60 ± 3.27 and 18.40 ± 3.26 s, respectively (p < 0.0005). ILMA proved more successful than the I-gel regardless of compressions. Continuation of compressions caused a prolongation in intubation times for both the I-gel (p < 0.0005) and the ILMA (p < 0.0005). Conclusion: In this mannequin study, nursing staff can successfully intubate using the I-gel and the ILMA as conduits with comparable success rates, regardless of whether chest compressions are interrupted or not. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to develop a novel intravascular loopless monopole antenna (ILMA) design specifically for imaging of small vessel walls. The ILMA consisted of an unshielded, low-friction guide wire and a tuning/matching box. The material of the guide wire was nitinol and it was coated with polyurethane. Because the guide wire was unshielded, it could be made thinner than the coaxial cable-based loopless intravascular antenna design. The material of the box was aluminum. In this study, the diameter of the guide wire was 0.5 mm and the length was 58.7 mm. The ILMA was used as a receiving antenna and body coil for transmission. To verify the feasibility of the ILMA, in vitro and in vivo experiments were performed on a 3.0-T magnetic resonance (MR) scanner. In vitro tests using the ILMA indicated that the proposed design could be used to image target vessel walls with a spatial resolution of 313 μm at the frequency coding direction and more than 100 mm of longitudinal coverage. In vivo tests demonstrated that the images showed the vessel walls clearly by using the ILMA and also indicated that the ILMA could be used for small vessels. The proposed antenna may therefore be utilized to promote MR-based diagnoses and therapeutic solutions for cardiovascular atherosclerotic diseases. [Copyright &y& Elsevier]

Background: To identify dialysis patients with low fetuin-A levels, a sensitive immunoluminometric assay (ILMA) was developed. Methods: For the two-site ILMA, one monoclonal antibody was coated to polystyrene beads and one polyclonal antibody was labelled with acridinium ester. Results: The lower detection threshold was 0.013 g/L, with the normal range 0.20-0.87 g/L (arithmetic mean 0.437 ± 0.118 g/L). Serum fetuin-A levels in the dialysis patients were significantly lower (arithmetic mean: 0.352 ± 0.099 g/L, p < 0.0001). Conclusion: This ILMA has been proved to be a reliable method for the determination of serum fetuin-A concentrations in dialysis patients. [ABSTRACT FROM AUTHOR]

: ObjectivesThe goal of this study was to investigate plasma levels of myotrophin in heart failure (HF) and their relationship to gender and disease severity.: BackgroundMyotrophin is a myocardial hypertrophy-inducing factor initially demonstrated in hypertrophied and cardiomyopathic hearts. Recent evidence suggests an interaction with the transcription factor nuclear factor kappa B (NFκB), which is activated in HF and modulates myocardial protein expression. It is unknown whether this peptide has an endocrine/paracrine role in man. We hypothesized that it may have a role in HF and would be raised in plasma.: MethodsWe developed a competitive binding assay specific for human myotrophin. Myotrophin was measured in plasma extracts of 120 HF patients and 130 age- and gender-matched normal controls.: ResultsMyotrophin in plasma existed as the full-length 12 kD form with also a 2.7 kD form (possibly a degradation product). Log normalized myotrophin levels were significantly elevated in HF patients (mean ± SEM [geometric mean, range], 2.402 ± 0.021 [252, 72 to 933] vs. 2.268 ± 0.021 [185, 28 to 501] fmol/ml, p < 0.0005). There was no relationship between myotrophin and age or gender in controls. However, males with HF had higher levels of myotrophin than females (p < 0.001). There was an inverse relationship of myotrophin levels with New York Heart Association class in patients with no gender difference in the relationship.: ConclusionsThere is evidence of early activation of the myotrophin system in HF, which is more evident in males. This response is attenuated in more severe disease. The contribution of myotrophin to NFκB-mediated gene transcription and preservation of cardiac muscle mass remains to be investigated further. [Copyright &y& Elsevier]

Copyright of Anaesthesist is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fixed flexion deformity is a sequel of burns and their release under anaesthesia pose difficulty during intubation. Various modalities are used for airway management in such cases. Here we present the successful airway manage-ment in a patient with post burn contracture who was managed with use of intubating laryngeal mask airway (ILMA) introduced in reverse direction with 180 0 rotation for insertion.

Takayasu arteritis is a chronic progressive inflammatory vasculitis affecting aorta and its branches. We discuss a 24 year old posted for post partum sterilization. Patient had weak carotid pulsation on right and absent pulsations on left side. We used Intubating Laryngeal Mask Airway(ILMA) #4 to intubate the patient preventing any extension of the neck.

Introduction: The efficacy of an intubation technique is crucial to the success of ventilation therapies. Intubating laryngeal mask airway (ILMA), Macintosh and McGrath techniques are yet to be evaluated thoroughly. Orotracheal intubations with ILMA, McGrath, and Macintosh laryngoscopes are compared based on haemodynamic changes, time taken for intubations, and success rate., Material and Methods: This is a prospective, single-blinded, randomised controlled trial. Primary outcome: identification of the most efficient intubation technique. Secondary outcomes: haemodynamic parameters, time taken for intubation and the rate of success of intubation. Patients enrolled: 90. Groups: 3. Each participant is randomly assigned to a group. Inclusion criteria: both sexes, age: 18-55 years, ASA: I or II, Mallampati < III, Mouth opening > 2 fingers, BMI < 40 kg m-2, any elective surgery, general anaesthesia requiring endotracheal intubation. The haemodynamic changes, time taken for intubations, and success rate during ILMA, Macintosh and McGrath intubations were recorded and statistically analysed., Results: Macintosh and ILMA raised the heart rate (min-1) more than McGrath at the second minute (95% CI: 76.50 ± 1.34 [McGrath] < 81.73 ± 1.46 [Macintosh] < 90.42 ± 1.24 [ILMA]). ILMA required the longest intubation time (s) (95% CI: 71.64 ± 2.14 [ILMA] > 40.26 ± 1.36 [McGrath] > 30.63 ± 1.53 [Macintosh]). Macintosh and McGrath intubations were all successful, whereas ILMA recorded two failures. However, the observed failures were statistically insignificant (95% CI: 93.33 ± 4.35%)., Conclusions: McGrath intubation is the most efficient technique based on its haemodynamics. ILMA required the longest intubation time and statistically, rates of success of the techniques are alike.

Background and aim The primary aim of the study was to compare the intubation characteristics and effectiveness of intubating laryngeal mask airway (ILMA) and Ambu® Aura-i™ as a conduit for facilitating fiberoptic-guided intubation. Methods Eighty patients were enrolled in the randomized-controlled hospital-based study. After inducing general anesthesia, an appropriately sized ILMA (group 1)/Ambu Aura-I (group 2) was placed. Fiberoptic assessment of the glottic view was done followed by fiberoptic-guided tracheal intubation. The time taken for the insertion of ILMA/Ambu Aura-i, glottic view grading, time taken for fiberoptic-guided intubation, ease of intubation, time taken for the removal of ILMA/Ambu Aura-i were recorded. Data analysis was done using the two-tailed independent t-test, paired t-test, and Fisher's exact probability test. Result Anthropometric and airway parameters were similar in both groups. The success rate of the insertion of both devices was 100%. In group 1, the mean time taken for the insertion was 20.53±1.91, and it was 13.98±2.4 in group 2 (P<0.001S). Fiberoptic assessment of the glottic view in group 1 (ILMA group) was grade 1 in 80% of the patients, whereas it was 92% in group 2 (Ambu Aura-i) (P=0.54). The mean time taken for fiberoptic-guided intubation was 14.95±1.85 in group 1 and 14.15±1.37 in group 2 (P>0.001). No significant difference was observed according to the number of attempts in intubating through ILMA/Ambu Aura-i. Seventy-five percent (75%) in group 1 and 87.5% in group 2 were successfully inserted on the first attempt (𝑝 = 0.33). The time taken for the removal of the device was 11.87 +1.265 seconds in group 1 and 11.25±1.58 seconds in group 2 (P=0.054). Conclusion The Ambu Aura-i scores superiorly over ILMA in requiring less time for successful insertion on the basis of statistical analysis and hence appears to be a better independent ventilatory device., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Mishra et al.)

Background: Obesity causes various difficulties in intubation and ventilation, which are confronted due to increased fat tissue in the upper airway and diminished compliance in the chest wall. Videolaryngoscopes and Intubating Laryngeal Mask Airway (ILMA) are good options as recommended by the American Society of Anesthesologists (ASA) difficult airway guidelines. We aimed to compare ILMA and Airtraq (a channeled videolaryngoscope) in obese patients., Methods: Eighty patients with ASA physical status I-III, aged between 18 and 65 years and with a body mass index greater than 35 kg.m -2 , who were undergoing elective surgery requiring orotracheal intubation, were included in the study. Patients were intubated with one of the devices cited., Results: There was no difference between the number of intubation attempts, insertion times and need for optimisation manoeuvres of Airtraq and ILMA. The intubation with Airtraq was accomplished in a shorter period of time than in that in the ILMA group (29.9±22.1s vs. 50.7±21.2s; p<0.001). A significant difference was found when the times of total intubation were compared (29.9±22.1s vs. 97.4±42.7s; p<0.001). The mean arterial pressure statistically increased after device insertion in the ILMA group (p<0.05)., Conclusions: Airtraq appears to be superior to ILMA in obese patients, with a total of time intubation of less than 60 seconds and with low mean arterial pressure changes. However, ILMA is still a useful tool that provides both ventilation and intubation throughout the whole intubation process., (Copyright © 2020 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Background and Aims: The Ambu ® AuraGain • is a new single-use supraglottic airway device with gastric channel, designed to facilitate intubation. The study aimed to assess the success rates of proper placement and intubation using Ambu ® AuraGain • compared with intubating laryngeal mask airway (ILMA)., Methods: One hundred and twenty patients (18-60 years) were enrolled into this prospective, randomised, comparative study. After inducing general anaesthesia, appropriate size ILMA (group I)/Ambu ® AuraGain • (group A) was placed as per the manufacturer's recommendations and correct placement was confirmed. Appropriate size endotracheal tube was passed through the device. The success rate of insertion and intubation, number of attempts, Cormack-Lehane grading before insertion and haemodynamics were recorded. Data were analysed using Mantel-Haenszel Chi-square test, Student's t -test and Fisher's exact test., Results: Demographic and airway parameters were uniformly distributed in both the groups. The success rate for insertion was 100% in both devices. The success rate for intubation was 96.6% (58/60) in group I and 36.6% in group A ( P < 0.001). In group I, patients with mean thyromental distance >7.62 ± 0.75 cm had higher successful intubation compared with patients with mean thyromental distance <5.25 ± 0.35 cm ( P = 0.014). Cormack-Lehane grading did not correlate with intubation attempts or success rate in group I ( P = 0.45), whereas in group A the rate of successful blind intubation with Cormack-Lehane grade 1 was 50% (19/38)., Conclusion: Both devices have 100% insertion success, though Ambu ® AuraGain • has lower success rate for facilitating intubation compared with ILMA., Competing Interests: There are no conflicts of interest.