A Comparison Between Airtraq Optical Laryngoscope and Conventional Macintosh Laryngoscope for Intubation in Adult Surgical Patients: A Prospective Randomized Controlled Study
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 4
Abstract
Tracheal intubation using a laryngoscope is considered as a gold standard 1 of airway management during administration of general anesthesia and also in critical care settings because of its several advantages including 2,3- Isolation of respiratory tract from Gastro intestinal system and hence minimal risk of aspiration. Allows delivery of oxygen and anaesthetic gases via positive pressure ventilation without inflation of stomach. Access to tracheobronchial tree for pulmonary lavage and drug administration (e.g. inhaled bronchodilators). Improved access to head and neck surgeries. Airway management is important for anesthesia because adverse respiratory events are responsible for 75% of ASA closed claims. Of these failed ventilation is the main culprit (38%), followed by faulty placement of endotracheal tube in esophagus (17%) and difficult intubation (18%). Approximately 600 patients die each year in the developed world from complications due to airway management and also in the underdeveloped world is much grimmer.4,5,6 Context: We compared tracheal intubation using airtraq optical laryngoscope with macintosh laryngoscope in adult patients undergoing elective procedures under general anesthesia Aims: This study is to compare the intubating conditions in adult surgical patients using airtraq optical laryngoscope with macintosh laryngoscope with respect to ease of intubation, time taken for intubation, airway trauma and hemodynamic response to laryngoscopy. Settings and Design: Prospective randomised interventional study. Materials and Methods: This study was done in Sree Balaji Medical College and Hospital, Chennai at Department of Anaesthesiology and Critical Care from August 2016 to February 2018. It was a Single centre, prospective, randomized, parallel group, open label, interventional controlled study. After obtaining institutional ethical committee approval. 60 patients (sample size) who were posted for elective surgery requiring general anesthesia (Recruitment) with satisfying inclusion criteria were enrolled in the study after obtaining informed consent from the patients and relatives. 2 groups by random number allotted by computer based randomization Statistical Analysis: Descriptive and inferential statistical methods were used. Results: Mean duration of intubation with the Airtraq group was 15.93 secs whereas in the Macintosh group it was found to be 38.70 secs. It was computed using Levene’s T test and was found to be statistically significant. In the Macintosh group, 4 patients had an Total IDS of 5 or greater, indicating moderate to severe intubation difficulty, whereas no patient in the Airtraq group had an Total IDS of more than 3 and was found to be statistically significant. Conclusion: Our study concludes that endotracheal intubation is easier with Airtraq compared to Macintosh laryngoscope as it provides good glottis view. In addition to that Airtraq have less intubation duration, less hemodynamic response for intubation and less Airway trauma compared to Macintosh.
Authors and Affiliations
S Selvamani
Keywords
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- EP ID EP668122
- DOI 10.21088/ijaa.2349.8471.6419.48
- Views 86
- Downloads 0
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