Comparison of Airtraq Laryngoscope and Macintosh Laryngoscope in Patients Undergoing Tracheal Intubation with Simulated Cervical Spine Immobilization

Abstract

ABSTRACT

Introduction

Cervical spine immobilization using cervical collar is part of the recognized protocol of managing patients with actual or suspected cervical spine injury. The Airtraq laryngoscope makes it possible to intubate the airway with minimal optimization manoeuvre. This study sought to assess and compare tracheal intubation using Airtraq and Macintosh laryngoscopes in patients with simulated cervical spine immobilization.

Methodology

This was a randomized single blind prospective study among 58 consenting adults with ASA I and II scheduled for elective surgeries requiring intubation in Jos University Teaching Hospital (JUTH). Patients who had cervical collar were randomized into two equal groups; one group had tracheal intubation using Macintosh laryngoscope and the other with Airtraq laryngoscope. Duration of laryngoscopy and intubation, ease of intubation, haemodynamic response and complications were noted. Data was analysed using SPSS with students t-test and Chi square being statistical tests of choice. Significance was set at p=0.05.

Results

The study groups were comparable in characteristics (p=0.02). No significant statistical difference in intubation difficulty scale (IDS) between groups (p=0.08) with ease in intubation of 93.1% and 72.4% patients in Macintosh and Airtraq groups respectively. The duration of laryngoscopy and intubation was shorter in the Macintosh group compared with the Airtraq group (p=0.001). The intergroup differences in the haemodynamic responses to laryngoscopy was not statistically significant as well as the recorded complications between the study groups. 

Discussion

The comparable ease of intubation between Airtraq and Macintosh laryngoscopes is similar to those reported by some authors but at variance to other reports. Experience of laryngoscopist influences ease of intubation. Shortened duration of laryngoscopy and intubation with the Macintosh laryngoscope is reported in some studies but contrary findings were found in others. The fact that haemodynamic responses and complications were similar between Macintosh and Airtraq laryngoscope groups means that either can be used where proficiency is not in doubt.      

Keywords: Airtraq, Macintosh, Laryngoscope