Comparison of the single‐use Ambu® aScope™ 2 vs the conventional fibrescope for tracheal intubation in patients with cervical spine immobilisation by a semirigid collar

Summary Fibreoptic intubation remains a key technique for the management of difficult intubation. We randomly compared the second generation single‐use Ambu® aScope™ 2 videoscope with a standard re‐usable flexible intubating fibrescope in 50 tracheal intubations in patients with a difficult airway simulated by a semirigid collar. All patients’ tracheas were intubated successfully with the aScope 2 or the re‐usable fibrescope. The median (IQR [range]) time to intubate was significantly longer with the aScope 2 70 (55–97 [41?–226]) s vs 50 (40–59 [27–175]) s, p = 0.0003) due to an increased time to see the carina. Quality of vision was significantly lower with the aScope 2 (excellent 24 (48%) vs 49 (98%), p = 0.0001; good 22 (44%) vs 1 (2%), p = 0.0001; poor 4 (8%) vs 0, p = 0.12) but with no difference in the subjective ease to intubate (easy score of 31 (62%) vs 38 (76%), p = 0.19; intermediate 12 (24%) vs 7 (14%), p = 0.31; difficult 7 (14%) vs 5 (5%), p = 0.76). The longer times to intubate and the poorer scores for quality of vision do not support the use of the single‐use aScope 2 videoscope as an alternative to the re‐usable fibrescope.