Cervical spine movement during intubation using the Airtraq® and direct laryngoscopy

Abstract

To compare 2 endotracheal intubation techniques, namely direct laryngoscopy and Airtraq®, according to their influence on cervical spine movement and intubation time and success rates, complications, and hemodynamic responses. Materials and methods: Thirty three patients without cervical spine problems were enrolled in the study. Patients were randomized into direct laryngoscopy and Airtraq® groups. Assessment of movement of the cervical spine was made by taking 3 lateral cervical spine X-rays. First, when the cervical spine was in the neutral position, second during the greatest excursion of the cervical spine, and finally, after intubation. A reference line was drawn following the dorsal alignment of C2. Two other lines were drawn, one connecting the anterior and posterior arch of the atlas (C1) and the second through the basal plate of C3. The angle with the C1 arch line was called \alpha and with the C3 line was called \beta. Results: The duration of intubation was significantly longer in the Airtraq® group. Although there was a statistically borderline significant difference between groups during intubation at the mean change of \beta angle (P = 0.054), within group differences were similar in the 2 groups (P = 0.4). Conclusion: As a result, we do not recommend intubation via Airtraq® as an alternative to the direct laryngoscopy in cervical spine injuries.