Airtraq™ versus Macintoch laryngoscope in intubation performance in the pediatric population

Abstract

Purpose:Airtraq™ is an optical laryngoscope that allows viewing of the vocal cords without a direct line of sight. The main objective of this prospective, randomized, controlled trial was to evaluate Airtraq intubation characteristics, mainly intubation time and cardiovascular changes in the pediatric patients.Methods:Fifty children of American Society of Anesthesiologists class I, 2-10 years of age were divided into 2 groups using sealed envelope technique. Children were premedicated with midazolam. Anesthesia was induced with sevoflurane, fentanyl, and atracurium. Patients were randomly allocated to be intubated with either Airtraq (Airtraq group) or Macintosh laryngoscope (Macintosh group). Intubation time, number of intubation attempts, optimization maneuvers, and ease of intubation were recorded. Hemodynamic variables were recorded before and after anesthetic induction, 1, 3, and 5 min after tracheal intubation.Results:The mean age of children was 6.1 years. Compared with Macintosh group, the use of Airtraq was associated with shorter intubation time (51.6±26.7 s vs 22.8±6.1 s, respectively, P=0.001), less median number of intubation attempts 2 (1-2) versus 1 (1-1), P=0.001), more ease of intubation [2 (1-3) versus 1 (1-1), P=0.001] and less increase in the heart rate 5 min after intubation (P=0.007). No optimization maneuvers required for Airtraq laryngoscope (P=0.001).Conclusion:Airtraq decreases intubation time, number of attempts, and optimization maneuvers, less heart rate changes during intubation compared with Macintosh laryngoscope.

Airtraq, LMA CTrach and Macintosh Laryngoscopes in Tracheal Intubation Training: A Randomized Comparative Manikin Study

“…Even in situations where the spine is immobilized, the Airtraq device may also reduce the risk of intubation failure. Not only in adults but also in the paediatric population, the Airtraq was found to decrease the number of intubation attempts, the intubation time and the optimization manoeuvres, compared with the Macintosh laryngoscope (21). For children, the tracheal intubation time was longer and there was a statistically significant difference in intubation time between the Airtraq and Macintosh laryngoscopes (51.6±26.7 s vs. 22.8±6.1 s, respectively).…”

Pediatric video laryngoscope versus direct laryngoscope: a meta‐analysis of randomized controlled trials

“…Fourteen RCTs with a total of 993 participants were included in this meta‐analysis. The process of literature identification, screening, and selection is briefly summarized in Figure .…”

Are new supraglottic airway devices, tracheal tubes and airway viewing devices cost‐effective?

“…Both require a mouth opening >12 mm , which limits its universal applicability. There is some evidence using the original fully disposable version of the device to suggest that Airtraq ® decreases intubation time and number of intubation attempts in normal children compared with conventional laryngoscopy , though there are significant limitations with these small studies. The adult sizes of the Airtraq device can now be complimented with a Wi‐Fi camera which allows real‐time sharing of images and video recording of intubations with iPad ® , iPhone ® and PC.…”