Evaluate the use of video laryngoscope in facilitating endotracheal intubation in unanticipated difficult airways

Background: PENTAX Airway Scope (AWS-S100) is a fast, accurate and portable VIDEO LARYNGOSCOPE which incorporates advanced imaging technology with optimized ergonomic design. Utilizing a 2.4” high-resolution colour LCD video monitor, identification of anatomical structures can be easily obtained. When combined with the unique targeting system, fast and accurateplacement of the endotracheal (ET) tube is achieved during tracheal intubation.
Objectives:

1. To study the feasibility of laryngeal visualization using PENTAX Airway Scope (AWS-S100) video laryngoscope after an initial diagnosis of unanticipated difficult airway using a direct laryngoscope.
2. To study the time taken for endotracheal intubation in cases of unanticipated difficult airway.
3. To study complications of the procedure, if any

Methods: 100 consecutive ASA grade I and II patients scheduled for various surgical procedures with unexpected difficult airway were intubated with the PENTAX Airway Scope (AWS-S100) Video laryngoscope after confirmation of anticipated difficult airway( i.e. Cormack- lehane grade III & IV) on direct laryngoscopy. Induction of anaesthesia was standardized according to our institutional protocol. All tracheal intubations were performed by anaesthetists trained in the use of the PENTAX Airway Scope (AWS-S100) Video laryngoscope prior.
Results: Overall success rate was 100% (n = 100). Among all, in 90 patients trachea could be intubated in the firstattempt (90%). 10 patients were intubated in a second attempt (10%). In 98% of patients C-L grade improved from III & IV to I & II indicating good visualisation.Mean intubation time was 33.6s (range 10-94s). Complication included one incidence of lip trauma during intubation attempt.
Conclusion: Tracheal intubation with the PENTAX Airway Scope (AWS-S100) Video laryngoscope was feasible, safe and easy to perform in patients with unanticipated difficult airway, undergoing various surgical procedures. In all patients, a sufficient view of the vocal cords could be obtained. The
view of glottis was considerably improved on use of Pentax videolaryngoscope.