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- DOI 10.18231/j.ijca.2025.059
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Air-Q as an intubating LMA: Insights from a case series
Background and Aims: The Air-Q intubating laryngeal airway (ILA) is a second-generation supraglottic device designed for use as a bridging conduit in both conventional and fiberoptic intubation, particularly in difficult airway scenarios. This case series evaluates the performance of the Air-Q ILA in terms of ease of intubation, success rates, airway morbidity, and hemodynamic responses. While the device offers advantages like reduced hemodynamic stress and minimal airway trauma, limitations such as risks of regurgitation, aspiration, air leaks, and displacement remain considerations. This case series aimed to assess the efficacy of the Air-Q ILA as a conduit for endotracheal intubation, focusing on key performance metrics, including ease of use, success rates, airway morbidity, and hemodynamic responses.
Methodology: This case series included 15 patients of ASA I and II status, weighing 50–70 kg, scheduled for elective surgeries under general anesthesia requiring endotracheal intubation. After achieving adequate muscle relaxation, an Air-Q ILA size 3.5 was introduced. Device placement was confirmed by ensuring adequate ventilation and performing fiberoptic visualization using the Brimacombe and Berry scoring system.
A cuffed Portex endotracheal tube was inserted through the Air-Q device, and intubation was confirmed via capnography. The time taken for device placement (Air-Q insertion to ventilation confirmation) and tube insertion (intubation confirmation via capnography) was recorded. Ease of intubation and the number of attempts required were also noted. Standard ASA monitoring protocols were maintained throughout the procedure.
Results: Brimacombe and Berry score as per fiberoptic view was 4 in 9 patients and 3 in 2 patients and 1 in 4 patients. Mean Air-Q placement time was 18.04 + 1.39 seconds and tube placement time was 21 + 1.61 seconds. Successful intubation was achieved in 11 of 15 patients (73%), with 9 intubated on the first attempt and 2 on the second attempt.
Conclusion: The Air-Q ILA is an effective supraglottic device that provides both ventilation and a reliable conduit for blind intubation using standard endotracheal tubes. It facilitates shorter intubation times and minimizes hemodynamic stress, making it a valuable tool in airway management.
Keywords: Air-Q, Intubating laryngeal airway, Endotracheal intubation, Fiberoptic view, Hemodynamic response.
References
- Attarde VB, Kotekar N, Shetty SM. Air-Q intubating laryngeal airway: A study of the second generation supraglottic airway device. Indian J Anaesth. 2016;60(5):343–8.
- Bashandy GM, Boules NS. Air-Q the Intubating Laryngeal Airway: Comparative study of hemodynamic stress responses to tracheal intubation via Air-Q and direct laryngoscopy. Egypt J Anaesth. 2012;28:95–100.
- Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth. 1987;59(3):295–9.
- Endigeri A, Hulakund S, Rajanna R, Ganeshnavar A, Kelageri S, Sai Teja P. Comparison of Blockbuster LMA with Air-Q LMA for success of blind tracheal intubation in patients undergoing general anesthesia. J Anaesthesia and Pain. 2023;4(2):30–4.
- Benumof JL. Laryngeal mask airway: Indications and contraindications. Anesthesiology. 1992;77:843–50.
- El-Ganzouri AR, Marzouk S, Abdelalem N, Yousef M. Blind versus fiberoptic laryngoscopic intubation through Air-Q laryngeal mask airway. Egypt J Anaesth. 2011;27:213–8.
- Abbas DN, Abdghaffar EM. Comparison of the Air-Q intubating laryngeal airway versus the modified Williams intubating airway as aids for training in fiberoptic tracheal intubation. Ain Shams J Anaesthesiol. 2013;6(2):134–9.
- Brimacombe J, Berry A. A proposed fiber-optic scoring system to standardize the assessment of laryngeal mask airway position. Anesth Analg. 1993;76(2):457–8.
- Ha SH, Kim MS, Suh J, Lee JS. Self-pressurized Air-Q intubating laryngeal airway versus the LMA Classic: A randomized clinical trial. Can J Anesth. 2018;65:1003–10.
- Lee JR, Kim MS, Kim JT, Byon HJ, Park YH, Kim HS, et al. A randomized trial comparing the i-gel with the LMA Classic in children. Anaesthesia. 2012;67(6):606–11.
- Bashandy GM, Boules NS. Air-Q the intubating laryngeal airway: Comparative study of hemodynamic stress responses to tracheal intubation via Air-Q and direct laryngoscopy. Egypt J Anaesth. 2012;28(2):95–100.
- Kahl M, Eberhart LHJ, Behnke H, Sänger S, Schwarz U, Vogt S, et al. Stress response to tracheal intubation in patients undergoing coronary artery surgery: direct laryngoscopy versus an intubating laryngeal mask airway. J Cardiothorac Vasc Anesth. 2004;18(3):275–80.
- Karim YM, Swanson DE. Comparison of blind tracheal intubation through the intubating laryngeal mask airway (LMA Fastrach™) and the Air-Q™. Anaesthesia. 2011;66(3):185–90. 384 Patel et al / Indian Journal of Clinical Anaesthesia 2025;12(2):380–384
- R Badawi, Nashwa NM, Mohamed MA. Tips and tricks to increase the success rate of blind tracheal intubation through the Air-Q versus the intubating LMA Fastrach. Egypt J Anaesth. 2014;30(1):59–65.
- Attarde VB, Kotekar N, Shetty SM. Air-Q intubating laryngeal airway: A study of the second generation supraglottic airway device. Indian J Anaesth. 2016;60(5):343–8.
- El-Ganzouri AR, Marzouk S, Abdelalem N, Yousef M. Blind vs fiberoptic laryngoscopic intubation through Air-Q. Egypt J Anaesth. 2010;27:213–8.
How to Cite This Article
Vancouver
Patel SH, Azikakath SSM, Shrimali VB, Unadkat DP, Chandnani AS. Air-Q as an intubating LMA: Insights from a case series [Internet]. Indian J Clin Anaesth. 2025 [cited 2025 Oct 28];12(2):380-384. Available from: https://doi.org/10.18231/j.ijca.2025.059
APA
Patel, S. H., Azikakath, S. S. M., Shrimali, V. B., Unadkat, D. P., Chandnani, A. S. (2025). Air-Q as an intubating LMA: Insights from a case series. Indian J Clin Anaesth, 12(2), 380-384. https://doi.org/10.18231/j.ijca.2025.059
MLA
Patel, Shruti Hiteshkumar, Azikakath, Shaji Shara Manuel, Shrimali, Vishal Babubhai, Unadkat, Deep Pareshkumar, Chandnani, Anup shrichand. "Air-Q as an intubating LMA: Insights from a case series." Indian J Clin Anaesth, vol. 12, no. 2, 2025, pp. 380-384. https://doi.org/10.18231/j.ijca.2025.059
Chicago
Patel, S. H., Azikakath, S. S. M., Shrimali, V. B., Unadkat, D. P., Chandnani, A. S.. "Air-Q as an intubating LMA: Insights from a case series." Indian J Clin Anaesth 12, no. 2 (2025): 380-384. https://doi.org/10.18231/j.ijca.2025.059