Evaluation of the novel, single-use, flexible aScope for tracheal intubation in the simulated difficult airway and first clinical experiences.

Flexible fibreoptic intubation is widely accepted as an important modality for the management of patients with difficult airways. We compared the aScope, a novel, single-use, flexible video-endoscope designed to aid tracheal intubation, with a standard flexible intubating fibrescope, by examining the performance of 21 anaesthetists during an easy and difficult intubation simulation in a manikin. Intubation success, time for intubation, and rating of the devices (using a scale from 1, excellent to 6, fail) were documented. Intubation times were similar for both flexible 'scopes in the scenarios (p = 0.59). Successful intubation rates were higher for the standard intubating fibrescope (17/21, 81%) than the aScope (14/21, 67%; p = 0.02) in the difficult intubation scenario. The median (IQR[range]) ratings for the standard fibrescope vs the aScope were respectively: overall, 2 (1.75-2 [1-2.5]) vs 3 (2-3.25 [1-5]) (p < 0.0001); picture quality 2 (1.5-2 [1-3]) vs 3 (2-4 [1-5]) (p < 0.0001). The aScope was also successfully used to facilitate tracheal intubation in five patients with anticipated or unanticipated difficult airways. Picture quality was sufficient to identify the anatomical landmarks. Although the performance of the aScope is acceptable, it does not meet the current quality of standard flexible intubation fibrescopes.