title: Comparison of the single-use Ambu(®)  aScope™ 2 vs the conventional fibrescope for tracheal intubation in patients with cervical spine immobilisation by a semirigid collar*.
abstract: Fibreoptic intubation remains a key technique for the management of difficult intubation. We randomly compared the second generation single-use Ambu(®)  aScope™ 2 videoscope with a standard re-usable flexible intubating fibrescope in 50 tracheal intubations in patients with a difficult airway simulated by a semirigid collar. All patients' tracheas were intubated successfully with the aScope 2 or the re-usable fibrescope. The median (IQR [range]) time to intubate was significantly longer with the aScope 2 70 (55-97 [41?-226]) s vs 50 (40-59 [27-175]) s, p = 0.0003) due to an increased time to see the carina. Quality of vision was significantly lower with the aScope 2 (excellent 24 (48%) vs 49 (98%), p = 0.0001; good 22 (44%) vs 1 (2%), p = 0.0001; poor 4 (8%) vs 0, p = 0.12) but with no difference in the subjective ease to intubate (easy score of 31 (62%) vs 38 (76%), p = 0.19; intermediate 12 (24%) vs 7 (14%), p = 0.31; difficult 7 (14%) vs 5 (5%), p = 0.76). The longer times to intubate and the poorer scores for quality of vision do not support the use of the single-use aScope 2 videoscope as an alternative to the re-usable fibrescope.
authors.affiliation: Anaesthesiology Department, University Hospital Centre and University of Lausanne, Lausanne, Switzerland.
authors.forename: V
authors.initials: V
authors.lastname: Krugel
authors.forename: I
authors.initials: I
authors.lastname: Bathory
authors.forename: P
authors.initials: P
authors.lastname: Frascarolo
authors.forename: P
authors.initials: P
authors.lastname: Schoettker
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D020680:Bronchoscopes; D001999:Bronchoscopy; D002574:Cervical Vertebrae / Q000033:anatomy & histology*; D004209:Disposable Equipment; D023381:Endpoint Determination; D017743:Equipment Reuse; D005260:Female; D005336:Fiber Optic Technology; D005500:Follow-Up Studies; D006801:Humans; D007103:Immobilization / Q000379:methods*; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D008297:Male; D009333:Neck / Q000033:anatomy & histology; D012121:Respiration, Artificial; D018401:Sample Size; D016896:Treatment Outcome