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Randomized Controlled Trial
. 2014 Jul 16:14:144.
doi: 10.1186/1472-6920-14-144.

Teaching tracheal intubation: Airtraq is superior to Macintosh laryngoscope

Hong Zhao, Yi Feng  1 , Yanyan Zhou
Affiliations
Randomized Controlled Trial

Teaching tracheal intubation: Airtraq is superior to Macintosh laryngoscope

Hong Zhao et al. BMC Med Educ. .

Abstract

Background: Tracheal intubation with Macintosh laryngoscope is taught to medical students as it is a lifesaving procedure. However, it is a difficult technique to learn and the consequences of intubation failure are potentially serious. The Airtraq optical laryngoscope is a relatively novel intubation device, which allows visualization of the glottic plane without alignment of the oral, pharyngeal, and tracheal axes, possessing advantages over Macintosh for novice personnel. We introduced a teaching mode featured with a progressive evaluation scheme for preparation and performance of tracheal intubation with medical students in this prospective randomized crossover trial who had no prior airway management experience to find the superior one.

Methods: Twenty-six medical students of the 8-year programme in the 6th year participated in this trial, when they did their one-week rotation in the department of anaesthesiology. Each of the students intubated 6 patients, who were scheduled for surgeries under general anaesthesia, each laryngoscope for 3 patients respectively. One hundred and forty-nine consecutive patients scheduled for surgical procedures requiring tracheal intubation were enrolled. Patients were randomly allocated to undergo tracheal intubation using Macintosh (n = 75) or Airtraq (n =74) laryngoscope. The progressive evaluation scheme was applied to each intubation attempt.

Results: Intubation success rate was significantly higher in Airtraq group than Macintosh group (87.8% vs. 66.7%, P < 0.05). Duration of glottis exposure was significantly shorter in Airtraq group compared to Macintosh group (50 ± 19 s vs. 81 ± 27 s, P < 0.001). A grade I Cormack and Lehane glottic view was obtained in 94.6% of patients in the Airtraq group versus 32% of patients in the Macintosh group (P <0.001). Duration of intubation in Airtraq group was significantly shorter (68 ± 21 s vs. 96 ± 22 s, P < 0.05) compared to Macintosh group.

Conclusions: Airtraq laryngoscope is easier to master for novice personnel with a higher intubation success rate and shorter intubation duration compared with the Macintosh laryngoscope.

Trial registration: Trial registration number is ChiCTR-TRC-13003987, approval date Dec 12, 2013.

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Figures

Figure 1
Figure 1
Two laryngoscopes and Cormack-Lehane classification of glottis exposure. Left is Macintosh laryngoscope, middle is Airtraq optical laryngoscope.
See this image and copyright information in PMC

References

    1. Scott JBP. How did the macintosh laryngoscope become so popular? Pediatr Anesth. 2009;19:24–29. - PubMed
    1. Mulcaster JT, Mills J, Hung OR, MacQuarrie K, Law JA, Pytka S, Imrie D, Field C. Laryngoscopic intubation: learning and performance. Anesthesiology. 2003;98(1):23–27. - PubMed
    1. Greenland KB, Edwards MJ, Hutton NJ, Challis VJ, Irwin MG, Sleigh JW. Changes in airway configuration with different head and neck positions using magnetic resonance imaging of normal airways: a new concept with possible clinical applications. Br J Anaesth. 2010;105(5):683–690. - PubMed
    1. Maharaj CHHB, Harte BH, Laffey JG. Evaluation of intubation using the Airtraq or Macintosh laryngoscope by anaesthetists in easy and simulated difficult laryngoscopy: a manikin study. Anaesthesia. 2006;61:469–477. - PubMed
    1. Maharaj CH, Costello JF, Higgins BD, Harte BH, Laffey JG. Learning and performance of tracheal intubation by novice personnel: a comparison of the Airtraq and Macintosh laryngoscope. Anaesthesia. 2006;61(7):671–677. - PubMed

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