Comparing Airway Management Devices in Cervical Spine Immobilization: A Study of Intubation Characteristics
Alternative methods for tracheal intubation such as using a flexible intubation scope, video laryngoscope, and supraglottic airway device are recommended for patients with cervical spine injuries to prevent worsening of cord injuries. This research compared how effectively the BlockBuster laryngeal mask airway, King Vision video laryngoscope, and flexible intubation scope performed in patients with simulated cervical spine immobilization. Recent study compared the intubation characteristics of BlockBuster laryngeal mask airway (BBLM), King Vision video laryngoscope (KVVL), and flexible intubation scope (FIS) in adult patients with simulated immobilized cervical spine. A total of 120 adult patients were randomized into Group BBLM, Group KVVL, and Group FIS. The primary outcomes studied were the time to intubation, first-attempt success rate, and complications observed during intubation.
Results on Intubation Characteristics
The results indicated a significant difference in the mean total time for intubation among the groups, with BBLM and KVVL demonstrating faster intubation times compared to FIS. The success rate of the first attempt did not differ significantly between the groups, with rates of 75% for BBLM, 77% for KVVL, and 82.5% for FIS. Complications such as mucosal damage, esophageal intubation, sore throat, and cough were found to be comparable across all three devices.
Comparison of Intubation Time and Success Rates
Further analysis revealed that the time to intubation was significantly longer in the FIS group compared to the BBLM and KVVL groups. The study also compared its findings with previous research, noting differences in intubation times and success rates among different devices used for airway management in patients with cervical spine injuries.
Limitations of the Study
Limitations of the study included potential biases due to non-blinding of observers and anaesthetists, as well as the simulated nature of the environment, which may not fully replicate real-world scenarios. The study suggested that future research should explore the clinical utility of BBLM and KVVL in patients with cervical spine injuries and consider post-anesthesia induction with a cervical collar for improved clinical relevance and reproducibility.
Conclusion
Overall, the study concluded that BlockBuster LMA and King Vision video laryngoscope provided similar total times for intubation in patients with simulated immobilized cervical spines, while flexible intubation scope required a longer time for intubation compared to the other devices. Further studies in actual patients with cervical spine injuries are needed to validate these findings and assess the devices' clinical effectiveness.
Key Points
- The study compared the intubation characteristics of BlockBuster laryngeal mask airway (BBLM), King Vision video laryngoscope (KVVL), and flexible intubation scope (FIS) in adult patients with simulated immobilized cervical spine.
- The primary outcomes studied were the time to intubation, first-attempt success rate, and complications observed during intubation.
- Results showed that BBLM and KVVL had faster intubation times compared to FIS in adult patients with simulated immobilized cervical spine.
- The first-attempt success rate did not significantly differ between the groups, with rates of 75% for BBLM, 77% for KVVL, and 82.5% for FIS.
- Complications such as mucosal damage, esophageal intubation, sore throat, and cough were found to be comparable across all three devices.
- The study acknowledged limitations such as potential biases due to non-blinding of observers and anaesthetists, as well as the simulated nature of the environment, suggesting the need for further research in actual patients with cervical spine injuries to validate the findings.
Reference -
Neha Sinha et al. (2025). Comparison Of BlockBuster® Laryngeal Mask Airway, King Vision® Video Laryngoscope, And Flexible Intubation Scope For Orotracheal Intubation In Adult Patients With Simulated Immobilised Cervical Spine: A Randomised Controlled Trial. *Indian Journal Of Anaesthesia*. https://doi.org/10.4103/ija.ija_509_24.
