A randomized controlled trial comparing Macintosh laryngoscope and Airtraq video laryngoscope for endotracheal intubation in patients with thyroid swelling

Abstract

Background: Patients with thyroid swelling are anticipated difficult airway due to the anatomical complications associated with it leading to restricted neck movements and distorted laryngeal anatomy. The aim of this randomized prospective study was to compare Macintosh laryngoscope and Airtraq video laryngoscope for endotracheal intubation in patients with thyroid swelling. Methods: Eighty adult American Society of Anesthesiologist (ASA) grades I-II patients were taken and randomly divided into two groups of 40 patients in each. After induction of general anesthesia, tracheal intubation was done with either of the technique using a flexometallic tube. Time taken for intubation, hemodynamic variations during and after intubation, any optimization maneuver used during intubation, Cormack-Lehane score, Percentage of Glottic Opening (POGO score), Intubation Difficulty Score (IDS), and postoperative airway symptoms were noted. Results: Mean time required for intubation with Airtraq was more than Macintosh; P = 0.003. But Cormack-Lehane score, IDS score, and POGO score were better in the Airtraq group. Hemodynamic variations in both groups were comparable. Optimization maneuver required and postoperative airway symptoms were more in the Macintosh group. Conclusion: In patients with thyroid swelling, Airtraq video laryngoscope provides better visualization of the glottis, requires less manipulation during intubation, and less post-operative complications than Macintosh laryngoscope but requires significantly more time for intubation.