ABSTRACT:

Background
Awake endotracheal intubation using the fiberoptic bronchoscope is the gold standard in morbid obese patients. It needs special skills and high training. The disposable Airtraq TM laryngoscope had been used for difficult intubation. It can have some advantages compared to the fiberoptic bronchoscope during awake orotracheal intubation.
Methods:
In this study, 60 morbid obese patients were randomly assigned to be intubated awake with either the fiberoptic bronchoscope(30 patients) or the Airtraq TM laryngoscope (30 patients). Time needed for intubation, the number of intubation attempts, success rate and complications were assessed in the two groups.
Results:
The time of intubation was significantly shorter in the Airtraq …show more content…
Anesthesiologists still have limited skills with awake fibreoptic intubation. (4,5)
The learning curve for intubation using the fiberoptic bronchoscope must be always developed in patients with normal airway and considered succeeded after at least 10 successful single attempt in less than 2 minute(6,7)
Airtraq TM optical laryngoscope, is a device for routine and difficult intubation. It has a curved blade with 2 side by side channels for endotracheal tube and optical system. This device affords good illumination view of the glottis with no more force applied and with no need for alignment of the oral, pharyngeal and laryngeal axes. Awake intubation with Airtraq TM can be a reasonable choice for patients with difficult airway.(8)

Fig 1: Airtraq TM …show more content…
Patients and methods:
This study was carried out in Tanta university hospital on 60 morbidly obese patients scheduled for elective surgery under general anesthesia. This study was performed from March to October 2015after approval of ethical committee and patients informed consent. Inclusion criteria included patient between 18-60 years of both sexes with body mass index 30kg/m2 or more with Malampati grade 3or 4 . Exclusion criteria included patients refusal, uncooperative patients like mental retardation, lack of communication, blindness, deafness, also we excluded any patients with other indication for awake intubation other than morbid obesity like oropharyngeal masses, had American Society of Anesthesiologists physical status IV or V, had respiratory tract pathology or coagulation disorders, required a nasal route for tracheal intubation, or were at risk of regurgitation–aspiration (previous upper gastrointestinal tract surgery, known hiatus hernia, esophageal reflux, peptic ulceration, or not fasted). Lastly, anticipated impossible intubation cases were also