Comparison of ease of intubation with Airtraq optical laryngoscope versus Macintosh laryngoscope in pediatric patients undergoing elective surgeries

Abstract

Background: The AirTraq optical laryngoscope has been extensively evaluated in adults; it improves the ease of intubation and is associated with less movement of the cervical spine. Studies on pediatric patients are necessary due to the differences in airway in comparison with adults. This study aimed to compare the ease of intubation with AirTraq and Macintosh laryngoscopes in pediatric patients as primary objective and hemodynamic changes and airway trauma as secondary objectives.

Methods: 60 children of American Society of Anaesthesiologists (ASA) class I-II, aged 1-7 years of either sex posted for routine surgery requiring tracheal intubation were randomly divided into 2 groups; Group-A AirTraq (n = 30) and Group-B Macintosh (n = 30). Intubation time, number of attempts, percentage of glottic opening (POGO) score, Visual Analogue Scale (VAS) were recorded. Hemodynamic variables noted at baseline, immediately after intubation (T0), 1, 3, and 5 min after intubation (T1, T2, T3). Airway trauma (if any) during intubation was also noted.

Results: The use of AirTraq in comparison with Macintosh laryngoscope was associated with shorter intubation time [(15.83±3.949s) and (19.83±5.066s), P=0.001], better POGO score (p<0.001), better VAS (P=0.001), less increase in heart rate 5 min after intubation (P=0.042) and less increase in MAP at 1,3 and 5 min post-intubation. Airway trauma occurred in 2 patients in Group-B and 0 patients in Group-A .

Conclusion: AirTraq decreases intubation time, provides better POGO score and ease of intubation, less hemodynamic changes during intubation when compared with Macintosh laryngoscope.