Summary The Airtraq® laryngoscope is a novel single use tracheal intubation device. We compared the Airtraq® 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 = 30) or Airtraq® (n = 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® resulted in modest improvements in the intubation difficulty score, and in ease of use. Tracheal intubation with the Airtraq® resulted in less alterations in heart rate. These findings demonstrate the utility of the Airtraq® laryngoscope for tracheal intubation in low risk patients.
The Glidescope and AWS laryngoscopes required more time but reduced intubation difficulty and improved glottic view over the Macintosh laryngoscope more than the Truview EVO2 laryngoscope when used in patients undergoing cervical spine immobilization.
SummaryThe Airtraq Ò Laryngoscope is a novel intubation device which allows visualisation of the vocal cords without alignment of the oral, pharyngeal and tracheal axes. We compared the Airtraq Ò with the Macintosh laryngoscope in simulated easy and difficult laryngoscopy. Twenty-five anaesthetists were allowed up to three attempts to intubate the trachea in each of three laryngoscopy scenarios using a Laerdal Ò Intubation Trainer followed by five scenarios using a Laerdal SimMan Ò Manikin. Each anaesthetist then performed tracheal intubation of the normal airway a second time to characterise the learning curve. In the simulated easy laryngoscopy scenarios, there was no difference between the Airtraq Ò and the Macintosh in success of tracheal intubation. The time taken to intubate at the end of the protocol was significantly lower using the Airtraq Ò
SummaryDirect laryngoscopic tracheal intubation is taught to many healthcare professionals as it is a potentially lifesaving procedure. However, it is a difficult skill to acquire and maintain, and, of concern, the consequences of poorly performed intubation attempts are potentially serious. The Airtraq Ò Laryngoscope is a novel intubation device which may possess advantages over conventional direct laryngoscopes for use by novice personnel. We conducted a prospective trial with 40 medical students who had no prior airway management experience. Following brief didactic instruction, each participant took turns in performing laryngoscopy and intubation using the Macintosh and Airtraq devices under direct supervision. Each student was allowed up to three attempts to intubate in three laryngoscopy scenarios using a Laerdal Ò Intubation Trainer and one scenario in a Laerdal Ò SimMan Ò Manikin. They then performed tracheal intubation of the normal airway a second time to characterise the learning curve for each device. The Airtraq provided superior intubating conditions, resulting in greater success of intubation, particularly in the difficult laryngoscopy scenarios. In both easy and simulated difficult laryngoscopy scenarios, the Airtraq decreased the duration of intubation attempts, reduced the number of optimisation manoeuvres required, and reduced the potential for dental trauma. The Airtraq device showed a rapid learning curve and the students found it significantly easier to use. The Airtraq appears to be a superior device for novice personnel to acquire the skills of tracheal intubation.
SummaryThe 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. The Airtraq Ò (Prodol Meditec S.A., Vizcaya, Spain) is a new single use laryngoscope designed to facilitate tracheal intubation in patients with both normal and difficult upper airway anatomy. As a result of the exaggerated curvature of the blade and an internal arrangement of optical components, a view of the glottis is provided without alignment of the oral, pharyngeal and tracheal axes. Our group has recently demonstrated that the performance of the Airtraq is superior to that of the Macintosh laryngoscope in patients at low risk for difficult intubation [1], and in patients undergoing simulated cervical immobilisation by means of manual in-line axial stabilisation [2]. The Airtraq also produced less haemodynamic stimulation in these patients, a potentially important advantage in certain clinical situations [1,2]. In manikin studies, the Airtraq performs better than the Macintosh laryngoscope in the simulated difficult airway when used by experienced [3], inexperienced [4] and even novice [5] laryngoscopists. Recent reports have highlighted the utility of the Airtraq in a number of difficult airway settings, including post traumatic asphyxia [6], in morbid obesity [7], and following failed conventional approaches to tracheal intubation [8].The purpose of this study was to evaluate the usefulness of this new device for use by experienced anaesthetists in a randomised controlled trial of patients at increased risk for difficult intubation. We hypothesised that, in comparison with the Macintosh laryngoscope, the use of the Airtraq would be result in reduced laryngoscopy times, lower intubation difficulty scale (IDS) scores, and reduced haemodynamic stimulation following intubation. Data relating to four of the patients included in this study that were not successfully intubated with the Macintosh laryngoscope ...
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