Comparison of the Macintosh and Airtraq laryngoscopes in morbidly obese patients: a randomized and prospective study (original) (raw)
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Anaesthesia, 2008
The Airtraq Ò , a novel single use indirect laryngoscope, has demonstrated promise in the normal and simulated difficult airway. We compared the ease of intubation using the Airtraq with the Macintosh laryngoscope, in patients at increased risk for difficult tracheal intubation, in a randomised, controlled clinical trial. Forty consenting patients presenting for surgery requiring tracheal intubation, who were deemed to possess at least three characteristics indicating an increased risk for difficulty in tracheal intubation, were randomly assigned to undergo tracheal intubation using a Macintosh (n = 20) or Airtraq (n = 20) laryngoscope. All patients were intubated by one of three anaesthetists experienced in the use of both laryngoscopes. Four patients were not successfully intubated with the Macintosh laryngoscope, but were intubated successfully with the Airtraq. The Airtraq reduced the duration of intubation attempts (mean (SD); 13.4 (6.3) vs 47.7 (8.5) s), the need for additional manoeuvres, and the intubation difficulty score (0.4 (0.8) vs 7.7 (3.0)). Tracheal intubation with the Airtraq also reduced the degree of haemodynamic stimulation and minor trauma compared to the Macintosh laryngoscope.
A Comparative Evaluation of Airtraq and Macintosh Laryngoscopes for Difficult Intubation
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Airtraq is an indirect laryngoscope that has demonstrated promise during endotracheal intubation in both normal and difficult airway scenarios. In this study, we have compared effect of Macintosh and Airtraq laryngoscopes on intubating conditions in patients at increased risk for difficult tracheal intubation in a randomised controlled trial. MATERIALS AND METHODS Eighty consenting patients presenting for surgery requiring tracheal intubation, who were deemed to possess at least two characteristics indicating an increased risk for difficulty in tracheal intubation were randomly assigned to undergo tracheal intubation using either a Macintosh (n= 40) or Airtraq (n= 40) laryngoscope. All patients were intubated by anaesthesiologists experienced in the use of both laryngoscopes. RESULTS Two patients were not successfully intubated with the Macintosh laryngoscope, but were intubated successfully with the Airtraq. Airtraq reduced the mean ± SD duration of 1 st intubation attempt (52.30 ± 36.14 seconds with Macintosh laryngoscope and 34.83 ± 17.45 seconds with Airtraq), mean ± SD duration of successful intubation attempt (45.29 ± 26.58 seconds with Macintosh laryngoscope and 33.18 ± 11.06 seconds with Airtraq), number of intubation attempts required for successful intubation, need for optimisation manoeuvres required during intubation and minor complications during intubation. CONCLUSION Airtraq reduced the difficulty of tracheal intubation compared with the Macintosh laryngoscope in these patients.
Sri Lankan Journal of Anaesthesiology, 2012
Background The Airtraq® is an optical laryngoscope which has been shown to improve the ease of intubation in patients with normal and difficult airway. Aims A comparison between Macintosh and Airtraq® laryngoscope have been made in this study regarding the time taken, number of attempts required to intubate and complications in both normal and difficult intubation scenarios. Method 50 adult patients of ASA grade I and II meant for routine surgical procedure were randomly divided into two groups of 25 patients each. The patients in both the groups received similar mode of anaesthesia and monitoring. Result The time required to intubate patients with different scenarios were significantly less when Airtraq® was used compared to the use of Macintosh laryngoscope(p<0.05), number of attempts required to successfully intubate patients were significantly less for Airtraq® assigned group of patients compared to Macintosh group. Conclusion Airtraq® should be encouraged in difficult intubation scenarios with a mouth opening of more than 16mm for adult patients.
Anaesthesia, 2006
The Airtraq Ò laryngoscope is a novel single use tracheal intubation device. We compared the Airtraq Ò with the Macintosh laryngoscope in patients deemed at low risk for difficult intubation in a randomised, controlled clinical trial. Sixty consenting patients presenting for surgery requiring tracheal intubation were randomly allocated to undergo intubation using a Macintosh (n ¼ 30) or Airtraq Ò (n ¼ 30) laryngoscope. All patients were intubated by one of four anaesthetists experienced in the use of both laryngoscopes. No significant differences in demographic or airway variables were observed between the groups. All but one patient, in the Macintosh group, was successfully intubated on the first attempt. There was no difference between groups in the duration of intubation attempts. In comparison to the Macintosh laryngoscope, the Airtraq Ò resulted in modest improvements in the intubation difficulty score, and in ease of use. Tracheal intubation with the Airtraq Ò resulted in less alterations in heart rate. These findings demonstrate the utility of the Airtraq Ò laryngoscope for tracheal intubation in low risk patients.
Anaesthesia, 2006
The Airtraq Ò laryngoscope is a novel single use tracheal intubation device. We compared the Airtraq Ò with the Macintosh laryngoscope in patients deemed at low risk for difficult intubation in a randomised, controlled clinical trial. Sixty consenting patients presenting for surgery requiring tracheal intubation were randomly allocated to undergo intubation using a Macintosh (n ¼ 30) or Airtraq Ò (n ¼ 30) laryngoscope. All patients were intubated by one of four anaesthetists experienced in the use of both laryngoscopes. No significant differences in demographic or airway variables were observed between the groups. All but one patient, in the Macintosh group, was successfully intubated on the first attempt. There was no difference between groups in the duration of intubation attempts. In comparison to the Macintosh laryngoscope, the Airtraq Ò resulted in modest improvements in the intubation difficulty score, and in ease of use. Tracheal intubation with the Airtraq Ò resulted in less alterations in heart rate. These findings demonstrate the utility of the Airtraq Ò laryngoscope for tracheal intubation in low risk patients.
A Comparative Study of Tracheal Intubation Characteristics Using Macintosh and Airtraq Laryngoscope
International Journal of Medical and Dental Sciences, 2014
Background: Direct laryngoscopy for endotracheal intubation with the Macintosh blade is most commonly used for establishing a patent airway. Airtraq Tm Optical Laryngoscope, does not require the alignment of the 3 airway axes for glottic visualization. Objective: We aim to compare these two laryngoscopes in view of laryngoscopic grading, ease of tracheal intubation and hemodynamic changes associated with laryngoscopy and intubation. Materials and Methods: 50 ASA I and II patients were randomly divided into Macintosh (M) group and Airtraq (A) group. Cormack Lehane grading, ease of intubation, laryngeal intubation time in secs and incidence of sore throat was noted. HR & BP was recorded at 0, 1, 3, 5 & 10 minutes following intubation. Unpaired 't' test compared inter-group data, while paired 't' test compared within group cardiovascular data. (p<0.05 statistically significant) Results: The demographic data of both groups were comparable. Cormack-Lehane grading was better in group A than in group M [grade I group A(84%) and group M(60%)]. The mean time for laryngeal intubation (Mean ± SD) for group A (8.3 ± 4.6 secs) and group M (20.46 ± 6.6 secs) (t = 7.6, p< 0.01). Ease of intubation was better in group A than group M. The rise in blood pressure and heart rate was significantly less in Group A as compared to Group M. Conclusion: Airtraq laryngoscope was superior to Macintosh laryngoscope as it provided better laryngoscopic views, shorter laryngoscopy and intubation time, easier intubation and the rise in heart rate and systolic blood pressure was significantly less.
Anesthesiology Research and Practice, 2011
Background and Objective. The Airtraq laryngoscope (Prodol Meditec, Vizcaya, Spain) is a novel tracheal intubation device. Studies, performed until now, have compared the Airtraq with the Macintosh laryngoscope, concluding that it reduces the intubation times and increase the success rate at first intubation attempt, decreasing the Cormack-Lehane score. The aim of the study was to evaluate if, in unskillful anesthesiology residents during the laryngoscopy, the Airtraq compared with the Macintosh laryngoscope improves the laryngeal view, decreasing the Cormack-Lehane score.Methods. A prospective, randomized, crossed-over trial was carried out on 60 patients. Each one of the patients were intubated using both devices by unskillful (less than two hundred intubations with the Macintosh laryngoscope and 10 intubations using the Airtraq) anesthesiology residents. The Cormack-Lehane score, the success rate at first intubation attempt, and the laryngoscopy and intubation times were compared...
Comparison of the Macintosh and Airtraq Laryngoscopes in Endotracheal Intubation Success
Turkish Journal of Anesthesia and Reanimation, 2015
Endotracheal intubation of patients is an effective method for controlling airway and breathing. However, laryngoscopy and endotracheal intubation is not easy in every case. There is a recent abundance of equipment used for controlling ventilation and intubation. Airtraq is one of those equipments. In this study, our main objective is to compare the success rates of the Airtraq and Macintosh (direct and classic) laryngoscopes in endotracheal intubation. Methods: In this single-center, prospective, randomized, clinical study was performed on 80 patients who were operated under general anesthesia, ASA I-II, 18-65 years old. Patients were intubated using two different endotracheal intubation tools. Group A was intubated using the Macintosh (direct and classic) laryngoscope, meanwhile Group B was intubated using the Airtraq laryngoscope. Patients' snoring complaints, modified Mallampati scores, sternomental distances, thyromental distances, interincisor distance measurements and Cormack-Lehane (C-L) laryngoscopic classification, upper lip bite test results, intubation time, number of intubation attempts, maneuvers and techniques used for facilitating intubation and complications arising from intubation were recorded. Results: There was a statistically significant difference between the groups in terms of C-L scores (p=0.041). In all, 8 patients in the Macintosh group, and 2 patients in the Airtraq group were C-L grade III. In intubation of the Airtraq group, only 3 patients required facilitating techniques, meanwhile in intubation of the Macintosh group 15 patients we had to use one or more facilitating maneuver. The rate of Mallampati scoring "difficult" was 4/6 in the Macintosh and 2/11 in Airtraq laryngoscopy groups (p=0.553). Conclusion: In cases with seemingly difficult intubations, we believe the Airtraq laryngoscope has an advantage over the Macintosh laryngoscope, owing to its better view of the oropharyngeal and glottic areas in addition to facilitating intubation in patients with limited head extension.
Anesthesia and Analgesia, 2009
BACKGROUND: Many manufacturers are producing videolaryngoscopes (VLSs) with differing specifications, user interfaces, and geometry. It is clinically relevant to know the relative performance of the blades. Visualization of the glottis and intubation are often problematic in (extremely) obese patients, and the new video technology may offer better functionality and performance. Although many tracheal intubations with direct laryngoscopy are performed with an unstyletted endotracheal tube, it is recommended to use a stylet for intubation using videolaryngoscopy. In this study, we compared 3 VLSs in morbidly obese patients undergoing intubation for elective surgery and tested whether it is feasible to intubate the tracheas of morbidly obese patients without using a stylet. METHODS: One hundred fifty consecutive adult morbidly obese patients (body mass index Ͼ35 kg/m 2 ) were randomly selected to receive one of 3 VLSs: GlideScope, Storz V-Mac™, and McGrath. Direct laryngoscopy scored the best possible view of the glottis; subsequently, the respective VLS was used, and the patient's trachea was intubated. Common preprocedural (e.g., Mallampati grade) and intraprocedural (Cormack-Lehane grade) metrics of intubation difficulty were measured, as well as the dependent variables of intubation time, number of attempts, and subjective difficulty. RESULTS: All 3 VLSs tested offered an equal or better view of the glottis compared with traditional direct laryngoscopy. The number of attempts necessary to intubate the trachea differed significantly among VLSs (average 2.6 Ϯ 1.0 attempts for the GlideScope, 1.4 Ϯ 0.7 for the Storz, and 2.9 Ϯ 0.9 for the McGrath VLS). The average intubation times were 33 Ϯ 18 s for the GlideScope, 17 Ϯ 9 s for the Storz, and 41 Ϯ 25 s for the McGrath VLS. CONCLUSIONS: In this study, the VLS with the Macintosh blade (Storz VLS) had a better overall satisfaction score, intubation time, number of intubation attempts, and necessity of extra adjuncts, compared with the 2 other tested devices. * Statistically significant difference over other tested videolaryngoscopes (P Ͻ 0.01). † Statistically significant difference over McGrathா VLS (P Ͻ 0.05).
Revista Española de Anestesiología y Reanimación (English Edition), 2018
Objective: To compare the haemodynamic response and effectiveness of tracheal intubation with Airtraq ® device and Macintosh laryngoscope, for airway management of patients between 2 and 8 years undergoing elective surgery. Methods: A prospective, comparative, randomised and blind clinical trial where the effectiveness of tracheal intubation in 80 paediatric patients undergoing elective surgery was determined. Patients were divided into 2 groups of 40 subjects each: group A, intubated with Airtraq ® optical laryngoscope; and group M, intubated with Macintosh laryngoscope. Haemodynamic changes, time and number of attempts at intubation and its complications were evaluated in both. Results: Heart rate was higher in group M from minute 1 to 5 with statistically significant difference (p: 0.001). The mean, systolic and diastolic blood pressure and EtCO 2 values were higher in group M. There were no statistically significant differences in SO 2. There was a statistically significant difference in time (group A: 18 ± 4 s, group M: 27 ± 7 s) and the number of attempts for intubation were lower for group A (p: 0.001). Seven patients in group M had post-intubation complications while only one subject had in group A. Conclusion: Intubation with Airtraq ® device is more effective than Macintosh laryngoscope in terms of reduction of haemodynamic changes, SO 2 , EtCO 2 , time and number of attempts for intubation and complications in paediatric patients undergoing elective surgery.