Fibreoptic intubation using three airway conduits in a manikin: the effect of operator experience.

In a randomised cross-over study, 72 anaesthetists (24 Senior House Officers, 24 Specialist Registrars and 24 Consultants) attempted to place a fibreoptic scope in the trachea of a manikin using three airway conduits: the Berman airway, the LMA Classic(trade mark) and the intubating laryngeal mask airway. The time for insertion of the airway conduit, delivery of two breaths and fibreoptic scope placement in the trachea was the primary endpoint. These overall times were significantly shorter (median [interquartile range]) using the LMA Classic (36 [28-45]) than via the intubating laryngeal mask (54 [42-79]) and the Berman airway (45 [33-80]), p < 0.0001. Senior House Officers were significantly slower than both Specialist Registrars and Consultants (p < 0.0001). The LMA Classic was considered to be the easiest conduit to use for fibreoptic scope placement by all grades of anaesthetists. We conclude that the LMA Classic is the most effective conduit for fibreoptic scope placement especially for anaesthetists with limited experience in its use.