Authors: Takashi Asai, M.D., Ph.D.
Anesthesiology 10 2016, Vol.125, 615-617.
REPEATED attempts at tracheal intubation increase the incidence of airway obstruction, leading to serious airway complications.1,2 Therefore, major guidelines for difficult airway management unanimously recommend avoiding repeated attempts at tracheal intubation.3–5 Much effort has been made to reduce the incidence of difficult intubation with a conventional Macintosh or Miller laryngoscope, but the incidence seems to remain the same. Technological development allows us to use alternative intubation devices, but it is not clear which device is most suitable to minimize repeated attempts at intubation. In this issue of Anesthesiology, Aziz et al.6 studied which alternative intubation devices were frequently used in patients after intubation with a conventional laryngoscope had failed and compared the successful rates of intubation with the following alternative “rescue” devices: a videolaryngoscope, a fiberoptic bronchoscope, a supraglottic airway (as a conduit for tracheal intubation), a lighted stylet, and an optical stylet.