With advances in technology, videoscopy and optic intubation have been gaining popularity, particularly in patients with difficult airways or as rescue devices in failed intubation attempts. Their routine use is, however, an uncommon occurrence. This review paper will summarise some of those newly developed devices currently available to assist tracheal intubation, their advantages, disadvantages when compared with the conventional laryngoscope and finally, evidence to support their use in both elective and emergency airway management.
ForeggerR.Richard von Foregger, Ph.D., 1872-1960: Manufacturer of Anesthesia Equipment. Anesthesiology1996; 84: 190–200.
2.
MaharajC.H., CostelloJ.F., HigginsB.D., HarteB.H., LaffeyJ.G.Learning and performance of tracheal intubation by novice personnel: a comparison of the Airtraq and Macintosh laryngoscope. Anaesthesia2006; 61: 671–677.
3.
CrosbyE.T., CooperR.M., DouglasM.J., DoyleD.J., HungO.R., LabrecqueP.The unanticipated difficult airway with recommendations for management. Can J Anaesth1998; 45: 757–776.
4.
LeeA., FanL.T., GinT., KarmakarM.K., Ngan KeeW.D.A systematic review (meta-analysis) of the accuracy of the Mallampati tests to predict the difficult airway. Anesth Analg2006; 102: 1867–1878.
5.
ShigaT., WajimaZ., InoueT., SakamotoA.Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. Anesthesiology2005; 103: 429–437.
6.
ChadwickR.G., LindsayS.M.Dental injuries during general anaesthesia. Br Dent J1996; 180: 255–258.
7.
KaplanM.B., HagbergC.A., WardD.S., BrambrinkA., ChhibberA.K., HeideggerT.Comparison of direct and video-assisted views of the larynx during routine intubation. J Clin Anesth2006; 18: 357–362.
8.
BoedekerB.H., BergB.W., BernhagenM., MurrayW.B.Direct versus indirect laryngoscopic visualization in human endotracheal intubation: a tool for virtual anesthesia practice and teleanesthesiology. Stud Health Technol Inform2008; 132: 31–36.
9.
JonesP.M., HarleC.C.Avoiding awake intubation by performing awake GlideScope® laryngoscopy in the preoperative holding area. Can J Anaesth2006; 53: 1264–1265.
10.
MurphyP.A fibre-optic endoscope used for nasal intubation. Anaesthesia1967; 22: 489–491.
11.
Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology2003; 98: 1269–1277.
12.
AlliaumeB., CoddensJ., DeloofT.Reliability of auscultation in positioning of double-lumen endobronchial tubes. Can J Anaesth1992; 39: 687–690.
13.
CheongK.F., KohK.F.Placement of left-sided double-lumen endobronchial tubes: comparison of clinical and fibreoptic-guided placement. Br J Anaesth1999; 82: 920–921.
14.
OvassapianA., RandelG.I.The role of the fiberscope in the critically ill patient. Crit Care Clin1995; 11: 29–51.
15.
JohnsonC., RobertsJ.T.Clinical competence in the performance of fiberoptic laryngoscopy and endotracheal intubation: a study of resident instruction. J Clin Anesth1989; 1: 344–349.
16.
OvassapianA., YelichS.J., DykesM.H., GolmanM.E.Learning fibreoptic intubation: use of simulators v. traditional teaching. Br J Anaesth1988; 61: 217–220.
17.
HughesS., SmithJ.E.Nasotracheal tube placement over the fibreoptic laryngoscope. Anaesthesia1996; 51: 1026–1028.
18.
JohnsonD.M., FromA.M., SmithR.B., FromR.P., MaktabiM.A.Endoscopic study of mechanisms of failure of endotracheal tube advancement into the trachea during awake fiberoptic orotracheal intubation. Anesthesiology2005; 102: 910–914.
19.
AsaiT., ShinguK.Difficulty in advancing a tracheal tube over a fibreoptic bronchoscope: incidence, causes and solutions. Br J Anaesth2004; 92: 870–881.
20.
PanditJ.J., DravidR.M., IyerR., PopatM.T.Orotracheal fibreoptic intubation for rapid sequence induction of anaesthesia. Anaesthesia2002; 57: 123–127.
21.
TrevisanutoD., FornaroE., VergheseC.The GlideScope video laryngoscope: initial experience in five neonates. Can J Anaesth2006; 53: 423–424.
22.
MilneA.D., DowerA.M., HackmannT.Airway management using the pediatric GlideScope in a child with Goldenhar syndrome and atypical plasma cholinesterase. Paediatr Anaesth2007; 17: 484–487.
23.
ChoJ.E., KilH.K.A maneuver to facilitate endotracheal intubation using the Glide Scope. Can J Anaesth2008; 55: 56–57.
24.
XueF., ZhangG., LiuJ., LiX., SunH., WangX.a clinical assessment of the Glidescope videolaryngoscope in nasotracheal intubation with general anesthesia. J Clin Anesth2006; 18: 611–615.
25.
CooperR.M., PaceyJ.A., BishopM.J., McCluskeyS.A.Early clinical experience with a new videolaryngoscope (GlideScope) in 728 patients. Can J Anaesth2005; 52: 191–198.
26.
TurkstraT.P., CraenR.A., PelzD.M., GelbA.W.Cervical spine motion: a fluoroscopic comparison during intubation with lighted stylet, GlideScope, and Macintosh laryngoscope. Anesth Analg2005; 101: 910–915.
27.
LimT.J., LimY., LiuE.H.Ease of intubation with the GlideScope or Macintosh laryngoscope by inexperienced operators in simulated difficult airways. Can J Anesth2004; 51: 641–642.
28.
LimT.J., LimY., LiuE.H.Evaluation of ease of intubation with the GlideScope or Macintosh laryngoscope by anaesthetists in simulated easy and difficult laryngoscopy. Anaesthesia2005; 60: 180–183.
29.
LimY., YeoS.W.A comparison of the Glide Scope with the Macintosh laryngoscope for tracheal intubation in patients with simulated difficult airway. Anaesth Intensive Care2005; 33: 243–247.
30.
XueF.S., ZhangG.H., LiX.Y., SunH.T., LiP., LiC.W.Comparison of hemodynamic responses to orotracheal intubation with the Glide Scope videolaryngoscope and the Macintosh direct laryngoscope. J Clin Anesth2007; 19: 245–250.
31.
JonesP.M., HarleC.C.Avoiding awake intubation by performing awake Glide Scope® laryngoscopy in the preoperative holding area. Can J Anaesth2006; 53: 1264–1265.
32.
DoyleJ.Awake intubation using the Glide Scope® video laryngoscope: initial experience in four cases. Can J Anaesth2004; 51: 520–521.
33.
CooperR.M.Complications associated with the use of the Glide Scope videolaryngoscope. Can J Anaesth2007; 54: 54–57.
34.
ShippeyB., RayD., McKeownD.Case series: the McGrath videolaryngoscope – an initial clinical evaluation. Can J Anaesth2007; 54: 307–313.
35.
ShippeyB., RayD., McKeownD.Use of the McGrath videolaryngoscope in the management of difficult and failed tracheal intubation. Br J Anaesth2008; 100: 116–119.
36.
KoyamaJ., AoyamaT., KusanoY., SeguchiT., KawagishiK., IwashitaT.Description and first clinical application of AirWay Scope for tracheal intubation. J Neurosurg Anesthesiol2006; 18: 247–250.
37.
NakamuraR., KusunokiS., KawamotoM.[Usability of modified INTLOCK for double-lumen endobronchial tube insertion with airway scope]. Masui2007; 56: 817–819.
38.
SuzukiA., KunisawaT., IwasakiH.Double lumen tube placement with the Pentax-Airway Scope. Can J Anaesth2007; 54: 853–854.
39.
AsaiT., EnomotoY., ShimizuK., ShinguK., OkudaY.The Pentax-AWS video-laryngoscope: the first experience in one hundred patients. Anesth Analg2008; 106: 257–259.
40.
HirabayashiY., SeoN.Tracheal intubation by non-anaesthetist physicians using the Airway Scope. Emerg Med J2007; 24: 572–573.
41.
HirabayashiY.Airway Scope: initial clinical experience with novice personnel. Can J Anaesth2007; 54: 160–161.
42.
SuzukiA., ToyamaY., KatsumiN., SasakiR., HirotaK., MatsumotoH.[Pentax-AWS improves laryngeal view compared with Macintosh blade during laryngoscopy and facilitates easier intubation]. Masui2007; 56: 464–468.
43.
HirabayashiY., SeoN.Airway Scope: early clinical experience in 405 patients. J Anesth2008; 22: 81–85.
44.
EnomotoY., AsaiT., AraiT., KamishimaK., OkudaY.Pentax-AWS, a new videolaryngoscope, is more effective than the Macintosh laryngoscope for tracheal intubation in patients with restricted neck movements: a randomized comparative study. Br J Anaesth2008; 100: 544–548.
45.
MaruyamaK., YamadaT., KawakamiR., KamataT., YokochiM., HaraK.Upper cervical spine movement during intubation: fluoroscopic comparison of the AirWay Scope, McCoy laryngoscope, and Macintosh laryngoscope. Br J Anaesth2008; 100: 120–124.
46.
HirabayashiY., FujitaA., SeoN., SugimotoH.Cervical spine movement during laryngoscopy using the Airway Scope compared with the Macintosh laryngoscope. Anaesthesia2007; 62: 1050–1055.
47.
LiuE.H., PoonK.H., NgB.S., GohE.Y., GoyR.W.The Airway Scope, a new video laryngoscope: its use in three patients with cervical spine problems. Br J Anaesth2008; 100: 142–143.
48.
KatoT., KusunokiS., KawamotoM., YugeO.[Usability of AirWay Scope for awake tracheal intubation in a burn patient with difficult airway]. Masui2007; 56: 1179–1181.
49.
SasanoN., YamauchiH., FujitaY.Failure of the Airway Scope to reach the larynx. Can J Anaesth2007; 54: 774–775.
50.
UeshimaH., AsaiT., ShinguK., InoueH., HashimotoY., EnomotoY.[Use of a gum elastic bougie for tracheal intubation with Pentax-AWS airway scope]. Masui2008; 57: 82–84.
51.
HirabayashiY., SeoN.The Airtraq laryngoscope for placement of double-lumen endobronchial tube. Can J Anaesth2007; 54: 955–957.
52.
DhonneurG., NdokoS.K., AmathieuR., AttiasA., HousseiniL.E., PolliandC.A comparison of two techniques for inserting the Airtraq laryngoscope in morbidly obese patients. Anaesthesia2007; 62: 774–777.
53.
DhonneurG., NdokoS., AmathieuR., HousseiniL.E., PonceletC., TualL.Tracheal intubation using the Airtraq in morbid obese patients undergoing emergency cesarean delivery. Anesthesiology2007; 106: 629–630.
54.
MaharajC.H., CostelloJ.F., HarteB.H., LaffeyJ.G.Evaluation of the Airtraq and Macintosh laryngoscopes in patients at increased risk for difficult tracheal intubation. Anaesthesia2008; 63: 182–188.
55.
MaharajC.H., BuckleyE., HarteB.H., LaffeyJ.G.Endotracheal intubation in patients with cervical spine immobilization: a comparison of macintosh and airtraq laryngoscopes. Anesthesiology2007; 107: 53–59.
56.
NdokoS.K., AmathieuR., TualL., PolliandC., KamounW., El HousseiniL.Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and Airtraq laryngoscopes. Br J Anaesth2008; 100: 263–268.
57.
DhonneurG., NdokoS.K., YavchitzA., FoucrierA., FessenmeyerC., PollianC.Tracheal intubation of morbidly obese patients: LMA CTrach vs direct laryngoscopy. Br J Anaesth2006; 97: 742–745.
58.
MaharajC.H., CostelloJ.F., McDonnellJ.G., HarteB.H., LaffeyJ.G.The Airtraq as a rescue airway device following failed direct laryngoscopy: a case series. Anaesthesia.2007; 62: 598–601.
59.
MaharajC.H., O'CroininD., CurleyG., HarteB.H., LaffeyJ.G.A comparison of tracheal intubation using the Airtraq or the Macintosh laryngoscope in routine airway management: A randomised, controlled clinical trial. Anaesthesia2006; 61: 1093–1099.
60.
MaharajC.H., CostelloJ.F., HarteB.H., LaffeyJ.G.Evaluation of the Airtraq and Macintosh laryngoscopes in patients at increased risk for difficult tracheal intubation. Anaesthesia2008; 63: 182–188.
61.
WoollardM., LightonD., MannionW., WattJ., McCreaC., JohnsI.Airtraq vs standard laryngoscopy by student paramedics and experienced prehospital laryngoscopists managing a model of difficult intubation. Anaesthesia2008; 63: 26–31.
62.
MaharajC.H., HigginsB.D., HarteB.H., LaffeyJ.G.Evaluation of intubation using the Airtraq or Macintosh laryngoscope by anaesthetists in easy and simulated difficult laryngoscopy – a manikin study. Anaesthesia2006; 61: 469–477.
63.
WoollardM., MannionW., LightonD., JohnsI., O'MearaP., CottonC.Use of the Airtraq laryngoscope in a model of difficult intubation by prehospital providers not previously trained in laryngoscopy. Anaesthesia2007; 62: 1061–1065.
64.
MaharajC.H., CostelloJ.F., HigginsB.D., HarteB.H., LaffeyJ.G.Learning and performance of tracheal intubation by novice personnel: a comparison of the Airtraq and Macintosh laryngoscope. Anaesthesia2006; 61: 671–677.
65.
MaharajC.H., Ni ChonghaileM., HigginsB.D., HarteB.H., LaffeyJ.G.Tracheal intubation by inexperienced medical residents using the Airtraq and Macintosh laryngoscopes – a manikin study. Am J Emerg Med2006; 24: 769–774.
66.
TimmermannA., RussoS., GrafB.M.Evaluation of the CTrach – an intubating LMA with integrated fibreoptic system. Br J Anaesth2006; 96: 516–521.
67.
LiuE.H., GoyR.W., ChenF.G.The LMA CTrach, a new laryngeal mask airway for endotracheal intubation under vision: evaluation in 100 patients. Br J Anaesth2006; 96: 396–400.
68.
BaskettP.J., ParrM.J., NolanJ.P.The intubating laryngeal mask. Results of a multicentre trial with experience of 500 cases. Anaesthesia1998; 53: 1174–1179.
69.
LiuE.H., GoyR.W., LimY., ChenF.G.Success of tracheal intubation with intubating laryngeal mask airways: a randomized trial of the LMA Fastrach and LMA CTrach. Anesthesiology2008; 108: 621–626.
70.
DhonneurG., NdokoS.K., YavchitzA., FoucrierA., FessenmeyerC., PollianC.Tracheal intubation of morbidly obese patients: LMA CTrach vs direct laryngoscopy. Br J Anaesth2006; 97: 742–745.
71.
LiuE.H., GoyR.W., ChenF.G.An evaluation of poor LMA CTrach views with a fibreoptic laryngoscope and the effectiveness of corrective measures. Br J Anaesth2006; 97: 878–882.
72.
AbdiW., NdokoS., AmathieuR., DhonneurG.Evidence of pulmonary aspiration during difficult airway management of a morbidly obese patient with the LMA CTrach. Br J Anaesth2008; 100: 275–277.
73.
BerciG., KatzR.Optical stylet: an aid to intubation and teaching. Ann Otol Rhinol Laryngol1979; 88: 828–831.
74.
KatzR.L., BerciG.The optical stylet – a new intubation technique for adults and children with specific reference to teaching. Anesthesiology1979; 51: 251–254.
75.
BonfilsP.[Difficult intubation in Pierre-Robin children, a new method: the retromolar route]. Anaesthesist1983; 32: 363–367.
76.
RudolphC., SchneiderJ.P., WallenbornJ., SchaffranietzL.Movement of the upper cervical spine during laryngoscopy: a comparison of the Bonfils intubation fibrescope and the Macintosh laryngoscope. Anaesthesia2005; 60: 668–672.
77.
WahlenB.M., GercekE.Three-dimensional cervical spine movement during intubation using the Macintosh and Bullard laryngoscopes, the bonfils fibrescope and the intubating laryngeal mask airway. Eur J Anaesthesiol2004; 21: 907–913.
78.
ByhahnC., NemetzS., BreitkreutzR., ZwisslerB., KaufmannM., MeiningerD.Brief report: Tracheal intubation using the Bonfils intubation fibrescope or direct laryngoscopy for patients with a simulated difficult airway. Can J Anaesth2008; 55: 232–237.
79.
BeinB., YanM., TonnerP.H., ScholzJ., SteinfathM., DorgesV.Tracheal intubation using the Bonfils intubation fibrescope after failed direct laryngoscopy. Anaesthesia2004; 59: 1207–1209.
80.
BeinB., WorthmannF., ScholzJ., BrinkmannF., TonnerP.H., SteinfathM.A comparison of the intubating laryngeal mask airway and the Bonfils intubation fibrescope in patients with predicted difficult airways. Anaesthesia2004; 59: 668–674.
81.
HalliganM., ChartersP.A clinical evaluation of the Bonfils Intubation Fibrescope. Anaesthesia2003; 58: 1087–1091.
82.
AbramsonS.I., HolmesA.A., HagbergC.A.Awake insertion of the Bonfils Retromolar Intubation Fiberscope in five patients with anticipated difficult airways. Anesth Analg2008; 106: 1215–1217.