Airtraq^® versus Macintosh laryngoscope: A comparative study in tracheal intubation

Abstract

Background:The curved laryngoscope blade described by Macintosh in 1943 remains the most widely used device to facilitate tracheal intubation. The Airtraq® (Prodol Meditec S.A, Vizcaya, Spain) is a new, single use, indirect laryngoscope introduced into clinical practice in 2005. It has wan exaggerated blade curvature with internal arrangement of optical lenses and a mechanism to prevent fogging of the distal lens. A high quality view of the glottis is provided without the need to align the oral, pharyngeal and tracheal axis. We evaluated Airtraq and Macintosh laryngoscopes for success rate of tracheal intubation, overall duration of successful intubation, optimization maneuvers, POGO (percentage of glottic opening) score, and ease of intubation.Materials and Methods:Patients were randomly allocated by computer-generated random table to one of the two groups, comprising 40 patients each, group I (Airtraq) and group II (Macintosh). After induction of general anesthesia, tracheal intubation was attempted with the Airtraq or the Macintosh laryngoscope as per group. Primary end points were overall success rate of tracheal intubation, overall duration of successful tracheal intubation, optimization maneuvers, POGO score and ease of intubation between the two groups.Results:We observed that Airtraq was better than the Macintosh laryngoscope as duration of successful intubation was shorter in Airtraq 18.15 seconds (±2.74) and in the Macintosh laryngoscope it was 32.72 seconds (±8.31) P < 0.001. POGO was also better in the Airtraq group 100% grade 1 versus 67.5% in the Macintosh group, P < 0.001. Ease of intubation was also better in the Airtraq group. It was easy in 97.5% versus 42.5% in the Macintosh group, P < 0.001.Conclusion:Both Airtraq and Macintosh laryngoscopes are equally effective in tracheal intubation in normal airways. Duration of successful tracheal intubation was shorter in the Airtraq group which was statistically significant.

A Comparative Evaluation of Airtraq and Macintosh Laryngoscopes for Difficult Intubation

“…The result was significant (p < 0.05) and in accordance withBhandari G et al (16) compared Airtraq with Macintosh laryngoscope for endotracheal intubation in 80 patients with normal airways. They found significant reduction (p < 0.05) in number of intubations requiring optimisation manoeuvres with Airtraq laryngoscope as compared to Macintosh laryngoscope.…”

The Macintosh Laryngoscope: the Mechanism of Laryngeal Exposure and the Optimal Maneuver

“…In a search of the PubMed database, the search criteria "new laryngoscope" identified 30 articles, while the search criteria "modified laryngoscope" identified 16 articles. However, the rationales for having many types of laryngoscopes, including video laryngoscopes, are not relevant to development of safer intubation devices [8,9]. Therefore, it is desirable to clarify the mechanisms of laryngeal exposure to allow the development of new safer intubation devices that are supported by theory.…”

Maintenance of Skill Proficiency for Emergency Skills With and Without Adjuncts Despite the Use of Level C Personal Protective Equipment

“…In recent years, the use of adjunct devices, such as video laryngoscopy (VL) and ultrasound, has become instrumental in the daily practice of emergency medicine. Conflicting evidence exists in the literature as to whether the use of PPE impedes the ability to simply successfully intubate, and this is further complicated by the impact of VL when using PPE [4][5][6][7][8][9][10][11][12]. While there is also conflicting evidence regarding the impact of ultrasound on intravenous (IV) cannulation, there are no studies that address its use with PPE [13][14].…”