Journal of Anesthesia 2008, 22:191-192.
Akihiro Suzuki, Asahikawa Medical College, Japan
According to the manufacturer’s manual, the AWS tip position should be inserted posterior to the epiglottis, directly elevating it out of the way (Miller-type approach), whereas it is recommended that the Airtraq tip be placed in the vallecula for indirect lifting of the epiglottis (Macintosh-type approach). For the Airtraq, the Miller-type approach is also possible as an alternative. But for the AWS, there is no description of an alternative (Macintosh-type) approach.
However, AWS intubation using a Macintosh-type approach failed in 12 of 15 attempts due to ETT impingement onto the epiglottis, whereas Airtraq intubation using the Miller type approach was successful in 15 of 15 attempts including 3 in which ETT impingement onto the arytenoid occurred, and this was easily solved by blade adjustment
It seems the Airtraq may have an advantage over the AWS because it provides versatility during intubation; with the Airtraq, one can use both anterior and posterior routes.
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