The Pentax airway scope versus the Macintosh laryngoscope: Comparison of hemodynamic responses and concentrations of plasma norepinephrine to tracheal intubation / 대한마취과학회지

BACKGROUND: The Pentax Airway Scope (AWS) is a video laryngoscope designed to facilitate tracheal intubation with a high-resolution image. The Pentax AWS has been reported to cause less hemodynamic stress than the Macintosh laryngoscope. The aims of this study are to investigate the differences in hemodynamic responses and norepinephrine concentrations to tracheal intubation between procedures using he Pentax AWS and the Macintosh laryngoscope. METHODS: Forty patients (American Society of Anesthesiologists class I-II, age range: 18-60 years) were randomly assigned to be intubated with either the Pentax AWS or the Macintosh laryngoscope while under general anesthesia. Routine monitoring, including invasive arterial blood pressure and bispectral index, were applied. Thiopental (4 mg/kg), fentanyl (1 microg/kg), midazolam (0.05 mg/kg), and rocuronium (0.6 mg/kg) were administered for anesthetic induction. Systolic, diastolic, and mean blood pressures and heart rates were recorded pre-intubation, immediately post-intubation (T0), and over the following 10 minutes at one minute intervals (T1, T2, T3, T4, T5em leaderT10). Patient blood was sampled for norepinephrine concentrations pre-intubation (baseline) and post-intubation (T1). Evidence of sore throat was evaluated 30 min and 24 hr after extubation. Data were transformed to % basal and expressed as mean +/- SD. RESULTS: The systolic, diastolic, and mean blood pressure, and heart rate at T0 and T4 were significantly different between the two groups. There was no significant difference in plasma norepinephrine between the two groups. The difference in incidence of sore throat was not significant between the two groups. CONCLUSIONS: Pentax-AWS for tracheal intubation has greater hemodynamic stability than the Macintosh blade laryngoscope.

A comparative study on the efficacy and cardiovascular response generated by macintosh and pentax-AWS video laryngoscopic endotracheal intubation methods / 대한마취과학회지

BACKGROUND: The Pentax-AWS is a newly developed rigid video laryngoscope. In comparison to the Macintosh laryngoscope, it offers a significantly improved laryngeal view and facilitates endotracheal intubation. The present study was performed to compare the general efficiency and the cardiovascular responses generated by Macintosh and Pentax-AWS systems during endotracheal intubation. METHODS: This study included 120 patients with American Society of Anesthesiologists (ASA) physical status class 1 or 2 requiring tracheal intubation for elective surgery. All patients were randomly allocated into two groups: Pentax-AWS (group P) and Macintosh (group M). Induction of anesthesia was performed using fentanyl, thiopental and succinylcholine intravenously. Systolic, mean and diastolic blood pressure (SBP, MBP, DBP) and heart rate (HR) were recorded just prior to induction, 1, 3, and 5 minutes after intubation. RESULTS: There were no significant differences in SBP, MBP, DBP and HR between both groups. However, group P showed a higher POGO (Percentage of Glottic Opening) score than group M during endotracheal intubation. CONCLUSIONS: Use of Pentax-AWS in endotracheal intubation did not increase hemodynamic changes compared to the use of Macintosh laryngoscope. Furthermore, Pentax-AWS offered an improved laryngeal view during endotracheal intubation.

The use of Pentax-Aws(R) for difficult intubation due to postburn contracture: Two cases report / 대한마취과학회지

The causes of difficult intubation associated with post-burn contracture from the face to the upper torso include the limitations of neck movement and opening the mouth. Fiberoptic oral intubation can be the final alternative technique that overcomes those difficulties. However, a small inter-incisor gap about 2 cm, a fixed head or neck position and the large tongue in these cases makes fiberoptic intubation difficult. The Pentax-AWS video display unit (Pentax-AWS(R), Pentax, Japan) (Pentax-AWS) allows indirect visualization of the glottis without a straightened line of orophalyngolaryngeal axis and its attached tracheal tube and this makes the intubation easier. We experienced rapid, easy intubation with Pentax-AWS following multiple attempts of fiberoptic intubation or confirming a bad glottic view with a Macintosh laryngoscope. Further study is needed on the availibility of Pentax-AWS and comparing it with fiberoptic intubation for the management of a difficult airway.