Comparative evaluation of Airtraq™ optical Laryngoscope and Miller's blade in paediatric patients undergoing elective surgery requiring tracheal intubation: A randomized, controlled trial

Abstract

Background and Aims:The Airtraq™ optical laryngoscope is the only marketed videolaryngoscope for paediatric patients besides the fibre-optic bronchoscope. We hypothesized that intubation would be easier with Airtraq™ compared to Miller blade. Hence, we compared Airtraq™ with the Miller laryngoscope as intubation devices in paediatric patients.Methods:This prospective, randomized study was conducted in a tertiary care teaching hospital. Sixty children belonging to American Society of Anesthesiologists' Grade I–II, aged 2–10 years, posted for routine surgery requiring tracheal intubation were randomly allocated to undergo intubation using a Miller (n = 30) or Airtraq™ (n = 30) laryngoscope. The primary outcome measure was time of intubation. We also measured ease of intubation, number of attempts, percentage of glottic opening score (POGO), haemodynamic changes and airway trauma. Student t test was used to analyse parametric data.Results:Intubation time was comparable between Miller's laryngoscope (15.13 ± 1.33s) compared to Airtraq™ (11.53 ± 0.49 s) (P = 0.29) The number of first and second attempts at intubation were 25 and 5 for the Miller laryngoscope and 29 and 1 for the Airtraq™. Median visual analogue score (VAS) for ease of intubation was 5 in Miller group compared to 3 in Airtraq™ group. The median POGO score was 75 in the Miller group and 100 in the Airtraq™ group (P = 0.01). Haemodynamic changes were maximum and most significant immediately and 1 min after intubation. Airway trauma occurred in three patients (9.09%) in Miller group and one patient (3.33%) in Airtraq™ group.Conclusion:The Airtraq™ reduced the difficulty of tracheal intubation and degree of haemodynamic stimulation compared to the Miller laryngoscope in paediatric patients.

Comparison of C-MAC Miller blade video laryngoscope with conventional Miller blade in infants undergoing elective surgery- A prospective randomised trial

“…who found a statistically significant better POGO score with VL compared to DL (P-value = 0.003, P value = 0.004, respectively). [ 15 , 20 ] Results similar to ours have been reported by Saran et al . who found a higher first-attempt intubation success rate in the VL group when compared with the DL group (83.3% versus 44.4%).…”

Comparison of Macintosh Laryngoscope and GlideScope® for Orotracheal Intubation in Children Older Than One Year

“…According to the VAS score, we did not find any superiority for ease of intubation as in the literature [20][21][22].…”

Effectiveness of Indirect and Direct Laryngoscopes in Pediatric Patients: A Systematic Review and Network Meta-Analysis

“…A further 202 studies were excluded for the following reasons: non-RCT (n = 56), manikin study (n = 41), case report (n = 33), review or meta-analysis (n = 22), different outcomes (n = 16), use of a flexible fiberscope (n = 11), use of a laryngeal mask (n = 7), observational study design (n = 7), adult patients (n = 4), guidelines (n = 3), and resuscitation research (n = 3). The remaining 34 articles met the inclusion criteria and contained the data necessary for the planned analysis ( Figure S3 ) [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ].…”

“…Patients included in these studies were aged 0 to 10 years. Based on pre-intubation airway assessment, 26 of 34 studies included patients with a normal airway [ 15 , 16 , 17 , 20 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 46 , 47 ], and 3 included patients with a difficult airway [ 35 , 36 , 45 ]. Five studies did not provide information on airway status [ 18 , 19 , 21 , 34 , 44 ].…”