title: Comparison of the air-Q intubating laryngeal airway and the cobra perilaryngeal airway as conduits for fiber optic-guided intubation in pediatric patients.
abstract: BACKGROUND
  One of the methods proposed in cases of difficult airway management in children is using a supraglottic airway device as a conduit for tracheal intubation. The aim of this study was to compare the efficacy of the Air-Q Intubating Laryngeal Airway (Air-Q) and the Cobra Perilaryngeal Airway (CobraPLA) to function as a conduit for fiber optic-guided tracheal intubation in pediatric patients.
  
  
  METHODS
  A total of 60 children with ages ranging from 1 to 6 years, undergoing elective surgery, were randomized to have their airway managed with either an Air-Q or CobraPLA. Outcomes recorded were the success rate, time and number of attempts required for fiber optic-guided intubation and the time required for device removal after intubation. We also recorded airway leak pressure (ALP), fiber optic grade of glottic view and occurrence of complications.
  
  
  RESULTS
  Both devices were successfully inserted in all patients. The intubation success rate was comparable with the Air-Q and the CobraPLA (96.7% vs. 90%), as was the first attempt success rate (90% vs. 80%). The intubation time was significantly longer with the CobraPLA (29.5 ± 10.9 s vs. 23.2 ± 9.8 s; P < 0.05), but the device removal time was comparable in the two groups. The CobraPLA showed a significantly higher ALP (20.8 ± 5.2 cmH2O vs. 16.3 ± 4.5 cmH2O; P < 0.001), but the fiber optic grade of glottic view was comparable with the two devices. The CobraPLA was associated with a significantly higher incidence of blood staining of the device on removal and post-operative sore throat.
  
  
  CONCLUSIONS
  Both the Air-Q and CobraPLA can be used effectively as a conduit for fiber optic-guided tracheal intubation in children. However, the Air-Q proved to be superior due to a shorter intubation time and less airway morbidity compared with the CobraPLA.
authors.affiliation: Department of Anesthesia, Faculty of Medicine, Cairo University, Giza, Egypt.
authors.forename: Karim K
authors.initials: KK
authors.lastname: Girgis
authors.affiliation: Department of Anesthesia, Faculty of Medicine, Cairo University, Giza, Egypt.
authors.forename: Maha M I
authors.initials: MM
authors.lastname: Youssef
authors.affiliation: Department of Anesthesia, Faculty of Medicine, Cairo University, Giza, Egypt.
authors.forename: Nashwa S
authors.initials: NS
authors.lastname: ElZayyat
keywords: Air-Q intubating laryngeal airway; cobra perilaryngeal airway; fiber optic-guided intubation; pediatric airway management; supraglottic airway devices