A comparative study of Airtraq？ and McCoy laryngoscopes for endotracheal intubation in adult patients with simulated difficult airway using a rigid cervical collar in elective surgeries under general anaesthesia

Background and Aims: Objective of intubation in patients with suspected neck injuries is sufficient laryngeal exposure with minimal cervical spine movement. Cervical collars reduce movements of spinebut result in difficult laryngoscopy. Airtraq, an indirect optic-laryngoscope allows high quality viewing of vocal cords with minimal neck movement without alignment of oropharyngolaryngeal axis. McCoy is a modification of standard laryngoscope with flexible tip. This study intends to compare efficacy of Airtraq and McCoy laryngoscopes for endotracheal intubation in adultpatients undergoing elective surgeries with simulated neck immobilisation using rigid cervical collar.

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Subjects and methods: Following approval from Institutional Ethical Committee, 60 consenting American Society of Anaesthesiologist's Physical Status (ASA PS) I-II patients, aged 18-65years were assigned into two groups by random sampling, namely Group A (Airtraq) or M (McCoy). Duration of one year with power 0.8 and alpha 0.05. Analysed by SPSS version 21. Intubation time, Intubation difficulty scale (IDS) and modified Cormack-Lehane grading were noted.

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Results: Mean intubation time was 27.2secs (6.47) and 40.2sec (12.36) for Airtraq and McCoy respectively (p-value < 0.0001). Median IDS values were 3 (Interquartile range (IQR) 1.25-4) and 0 for McCoy laryngoscopy and Airtraq, respectively (p< 0.0001). Median Cormack-Lehane glottic view was 2 and 1 for McCoy and Airtraq, respectively (p<0.0001). There were no failures to intubate in either group.

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Conclusion: Airtraq improves ease of intubation significantly when compared to McCoy blade with shorter intubation timeand IDS score, in patients with simulated neck immobilisatio