Comparison of Airtraq with Macintosh Laryngoscope for Endotracheal Intubation in Paediatric Patients: A Randomised Controlled Trial

Introduction: The Airtraq is a new intubation device that has been developed to facilitate tracheal intubation in patients with normal or difficult airway. The available paediatric sizes are 0, 1 and 2 and are of grey, purple, green colour. These can insert endotracheal tube of size 2.0-3.5/4-5.5/6-...

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Main Authors: Yogita Dwivedi, Ankit Jain, Vijay Pratap Yadav, Atiharsh Mohan Agarwal
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2022-03-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://www.jcdr.net/articles/PDF/16096/48692_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SC_SL)_PN(KM).pdf
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author Yogita Dwivedi
Ankit Jain
Vijay Pratap Yadav
Atiharsh Mohan Agarwal
author_facet Yogita Dwivedi
Ankit Jain
Vijay Pratap Yadav
Atiharsh Mohan Agarwal
author_sort Yogita Dwivedi
collection DOAJ
description Introduction: The Airtraq is a new intubation device that has been developed to facilitate tracheal intubation in patients with normal or difficult airway. The available paediatric sizes are 0, 1 and 2 and are of grey, purple, green colour. These can insert endotracheal tube of size 2.0-3.5/4-5.5/6-7.5, respectively. Aim: To evaluate the clinical efficacy of Airtraq laryngoscope in comparison with Macintosh by experienced Anaesthesiologist for intubation in paediatric patients. Materials and Methods: The randomised controlled trial was conducted at Sarojini Naidu Medical College, Agra, Uttar Pradesh, India, from December 2015 to August 2017. Fifty healthy children, aged 2-10 years of American Society of Anesthesiologists (ASA) grades I/II, presenting for elective surgery were randomly allocated in two equal groups. Endotracheal intubation was done either using Airtraq or Macintosh laryngoscope. Duration of intubation (primary variable), number of attempts, ease of intubation, oesophageal intubation, optimisation maneuvers, Percentage Of Glottic Opening (POGO) scoring and haemodynamic parameters were compared between two groups. Patients’ demographic data, intubation time, haemodynamic variables were analysed by Unpaired t-test. While number of attempts for intubation, ease of intubation, optimisation maneuvers and POGO scoring were analysed by Fisher’s-exact test. Data was presented as mean±SD with categorical data presented as frequency (n) and percentages (%). The p-value of <0.05 was considered as significant. Results: There was no difference in demographic variables and duration of surgery between two groups. Intubation time, which was taken as primary variable, was found to be significantly longer in Macintosh (56.28±6.02 sec) as compared to Airtraq (25.60±3.73 sec) with p-value <0.0001. In terms of ease of intubation and POGO scoring, Airtraq was better as compared to Macintosh. Haemodynamically, Airtraq was found to be better as compared to Macintosh reflected by postintubation heart rate which was 110±7.84 beats/min with Airtraq while 119.32±10.61 beats/min with Macintosh (p-value=0.0028). The two groups were statistically comparable in terms of number of attempts, optimisation maneuvers and mean blood pressure changes. Conclusion: It can be concluded that Airtraq is a reliable and promising alternative to Macintosh for endotracheal intubation in paediatric patients as seen by duration of intubation, better laryngeal view, ease of intubation and haemodynamic changes.
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spelling doaj.art-8b9d8e9b329a45e49472e1ba3ad2e3bb2023-02-07T09:43:41ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-03-01163UC16UC1810.7860/JCDR/2022/48692.16096Comparison of Airtraq with Macintosh Laryngoscope for Endotracheal Intubation in Paediatric Patients: A Randomised Controlled TrialYogita Dwivedi0Ankit Jain1Vijay Pratap Yadav2Atiharsh Mohan Agarwal3Associate Professor, Department of Anaesthesia, Government Medical College, Azamgarh, Uttar Pradesh, India.Senior Resident, Department of Anaesthesia, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.Assistant Professor, Department of Anaesthesia, Government Medical College, Azamgarh, Uttar Pradesh, India.Assistant Professor, Department of Anaesthesia, Government Medical College, Banda, Uttar Pradesh, India.Introduction: The Airtraq is a new intubation device that has been developed to facilitate tracheal intubation in patients with normal or difficult airway. The available paediatric sizes are 0, 1 and 2 and are of grey, purple, green colour. These can insert endotracheal tube of size 2.0-3.5/4-5.5/6-7.5, respectively. Aim: To evaluate the clinical efficacy of Airtraq laryngoscope in comparison with Macintosh by experienced Anaesthesiologist for intubation in paediatric patients. Materials and Methods: The randomised controlled trial was conducted at Sarojini Naidu Medical College, Agra, Uttar Pradesh, India, from December 2015 to August 2017. Fifty healthy children, aged 2-10 years of American Society of Anesthesiologists (ASA) grades I/II, presenting for elective surgery were randomly allocated in two equal groups. Endotracheal intubation was done either using Airtraq or Macintosh laryngoscope. Duration of intubation (primary variable), number of attempts, ease of intubation, oesophageal intubation, optimisation maneuvers, Percentage Of Glottic Opening (POGO) scoring and haemodynamic parameters were compared between two groups. Patients’ demographic data, intubation time, haemodynamic variables were analysed by Unpaired t-test. While number of attempts for intubation, ease of intubation, optimisation maneuvers and POGO scoring were analysed by Fisher’s-exact test. Data was presented as mean±SD with categorical data presented as frequency (n) and percentages (%). The p-value of <0.05 was considered as significant. Results: There was no difference in demographic variables and duration of surgery between two groups. Intubation time, which was taken as primary variable, was found to be significantly longer in Macintosh (56.28±6.02 sec) as compared to Airtraq (25.60±3.73 sec) with p-value <0.0001. In terms of ease of intubation and POGO scoring, Airtraq was better as compared to Macintosh. Haemodynamically, Airtraq was found to be better as compared to Macintosh reflected by postintubation heart rate which was 110±7.84 beats/min with Airtraq while 119.32±10.61 beats/min with Macintosh (p-value=0.0028). The two groups were statistically comparable in terms of number of attempts, optimisation maneuvers and mean blood pressure changes. Conclusion: It can be concluded that Airtraq is a reliable and promising alternative to Macintosh for endotracheal intubation in paediatric patients as seen by duration of intubation, better laryngeal view, ease of intubation and haemodynamic changes.https://www.jcdr.net/articles/PDF/16096/48692_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SC_SL)_PN(KM).pdfairwayglottic openingindirect laryngoscopy
spellingShingle Yogita Dwivedi
Ankit Jain
Vijay Pratap Yadav
Atiharsh Mohan Agarwal
Comparison of Airtraq with Macintosh Laryngoscope for Endotracheal Intubation in Paediatric Patients: A Randomised Controlled Trial
Journal of Clinical and Diagnostic Research
airway
glottic opening
indirect laryngoscopy
title Comparison of Airtraq with Macintosh Laryngoscope for Endotracheal Intubation in Paediatric Patients: A Randomised Controlled Trial
title_full Comparison of Airtraq with Macintosh Laryngoscope for Endotracheal Intubation in Paediatric Patients: A Randomised Controlled Trial
title_fullStr Comparison of Airtraq with Macintosh Laryngoscope for Endotracheal Intubation in Paediatric Patients: A Randomised Controlled Trial
title_full_unstemmed Comparison of Airtraq with Macintosh Laryngoscope for Endotracheal Intubation in Paediatric Patients: A Randomised Controlled Trial
title_short Comparison of Airtraq with Macintosh Laryngoscope for Endotracheal Intubation in Paediatric Patients: A Randomised Controlled Trial
title_sort comparison of airtraq with macintosh laryngoscope for endotracheal intubation in paediatric patients a randomised controlled trial
topic airway
glottic opening
indirect laryngoscopy
url https://www.jcdr.net/articles/PDF/16096/48692_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SC_SL)_PN(KM).pdf
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