Comparison of the BlockbusterTM and Air-Q® Supraglottic Airway Devices as a Conduit to Blind Endotracheal Intubation in Paediatric Patients: A Randomised Control Trial.

OBJECTIVE: Only two devices [air-Q® intubating laryngeal airway (ILA) and AmbuAura-i] have been studied previously for blind endotracheal intubation (ETI) in paediatric patients. The aim of the study was to compare the success rate of blind ETI through BlockbusterTM laryngeal mask (LM) and air-Q® ILA in paediatric patients. METHODS: Eighty patients with the American Society of Anesthesiologists' physical status I and II, aged between six months and 10 years, were enrolled in this randomised controlled trial. The patients were intubated through either of the supraglottic airway devices (SADs) by visualised, blind intubation. The primary outcome was the first- attempt success rate of ETI. Secondary outcomes were the overall success rate of ETI, the oropharyngeal leak pressure, the fiberoptic glottic view, the time to intubation, and the complication rate. RESULTS: BlockbusterTM LM was having significantly higher first attempt success rate without any manipulation as compared to air-Q® ILA (55% vs. 32.5%; P value =0.042). Overall success rate was also significantly higher in BlockbusterTM LM (77.5% vs. 55%; P value =0.03). In subgroup analyses, BlockbusterTM LM demonstrated significantly higher first-attempt and overall intubation success rates in children aged 6 months to 5 years, while success rates were comparable between devices among children older than 5 years. CONCLUSION: BlockbusterTM LM, having more than 50% success rate of first-attempt blind intubation through SAD, can be a helpful device in crises during airway management of children and, thus, an ideal SAD for difficult airway carts.