Bikramjit Das1*, Geeta Bhandari1, Kedar S. Shahi2, Subhro Mitra1, Aditya Kumar1
1Department of Anesthesiology, Govt. Medical College, Haldwani
2Department of Surgery, Govt. Medical College, Haldwani
Dr. Bikramjit Das, Govt. Medical College Campus, Haldwani - 263139, India.
Background: To compare safety and efficacy of Macintosh, McCoy or Airtraq laryngoscope in simulated difficult laryngoscopy using rigid neck collar.
Methods: It was a Prospective, randomized, controlled clinical trial conducted in a tertiary care teaching hospital. Patients with American Society of Anesthesiologist physical status I and II, age 18 to 60 years and scheduled recruited for elective surgery requiring general anesthesia with oral endotracheal intubation were included. The patients were divided into Macintosh, McCoy and Airtraq groups comprising of 40 patients each. Difficult laryngoscopy was simulated using rigid neck collar. Macintosh, McCoy and Airtraq laryngoscopes were used, respectively. The primary outcome measure was time of intubation. The secondary outcome measures were number of attempts, ease of intubation, overall success rate, modified Intubation Difficulty Score, Percentage of Glottic Opening score, hemodynamic parameters and complications.
Results: The time of intubation was significantly lower for Airtraq (27.80 sec) compared to Macintosh and MacCoy laryngoscopes (p = 0.04). Number of successful first intubation attempt was significantly higher in the Airtraq group compared to the other groups. The overall success rate was similar among groups. The median visual rating scale of the ease of intubation and the mean Intubation Difficulty Score were significantly lower and the median Percentage of Glottic Opening score was also significantly improved in the Airtraq group compared to the other groups.
Conclusion: The Airtraq optical laryngoscope allowed a shorter intubation time, fewer intubation attempts, and greater ease of intubation compared with the Macintosh and MacCoy laryngoscopes.