A comparison of cervical spine movement during laryngoscopy using the Airtraq^® or Macintosh laryngoscopes*

Abstract

The Airtraq laryngoscope has an oropharyngeal airway-shaped blade that provides a non-line-of-sight view of the glottis. The configuration of the blade should mean that less movement of the cervical spine is required during laryngeal visualisation. We compared the degree of cervical spine movement in laryngoscopy performed using the Airtraq and conventional Macintosh laryngoscope. In 20 patients requiring general anaesthesia and tracheal intubation, we measured cervical spine movement using radiography in the same patient during consecutive procedures using the two laryngoscopes. Although significant movement of the cervical spine from baseline was noted during all procedures (p < 0.05), cervical spinal extension with the Airtraq was 29% less than that measured during Macintosh laryngoscopy between the occiput and C4, and 44% less at the C3/C4 motion segment (p < 0.05). Anterior deviations of the vertebral bodies from baseline were 32%, 35%, 38% and 40% less at the atlas, C2, C3, and C4 vertebrae, respectively, during Airtraq laryngoscopy than those measured during Macintosh laryngoscopy (p < 0.01). Our study demonstrated that laryngoscopy using the Airtraq laryngoscope involves less movement of the cervical spine compared to conventional procedures using a Macintosh laryngoscope.

Tracheal intubation in patients with rigid collar immobilisation of the cervical spine: a comparison of Airtraq® and LMA CTrach™ devices*

“…In a study of morbidly obese patients where tracheal intubation was compared using the Airtraq and Macintosh laryngoscopes, the mean time taken for tacheal intubation was found to be shorter in the Airtraq group [19,20]. Hirabayashi et al [21] used fluoroscopy to study cervical spine movement during laryngoscopy using the Airtraq Table 1 Patients' status and pre-operative airway characteristics for patients whose tracheas were intubated using the Airtraq or CTrach device. Values are mean (SD) or number.…”

A randomised, controlled trial comparing the Airtraq™ optical laryngoscope with conventional laryngoscopy in infants and children*

“…The image can be viewed through the viewfinder or displayed on a wireless monitor. The Airtraq has been extensively evaluated in adults and, in particular, it improves the ease of intubation [4,5] and is associated with less movement of the cervical spine [6,7]. The paediatric Airtraq became available in the UK in May 2008 and is available in two sizes: infant (tracheal tube size 2.5-3.5 mm ID) and child (tracheal tube size 4.0-5.5 mm ID).…”

Comparison between the Airtraq, X-Lite, and direct laryngoscopes for thyroid surgery: a randomized clinical trial

“…29,30 Une méta-analyse confirme les résultats de ces études en montrant une réduction du temps de l'intubation au profit de l'Airtraq et une réduction de l'incidence du risque de l'intubation oesophagienne. 31 Les autres avantages de l'Airtraq sont le meilleur apprentissage de l'intubation, 32,33 la réduction du mouvement du rachis cervical 34 et la diminution du risque infectieux. 35 Chez nos patients, nous avons choisi comme critère de jugement principal le temps d'intubation.…”