Comparison of Airtraq and Trueview EVO2 with Macintosh Laryngoscope for Endotracheal Intubation by Experienced Anaesthesiologists: A Controlled Clinical Trial

Abstract

Background: The purpose of the study was to evaluate the efficacy of two new laryngoscopes by experienced anaesthesiologists. Airtraq and Truview EVO2 were compared with gold standard Macintosh laryngoscope for endotracheal intubation of elective surgical patients with normal airway distribution. Methods: In prospective, randomised and controlled manner 150 patients of either sex above 18 yrs, presenting for elective surgery were randomly allocated in three equal groups. Endotracheal intubation was done using either Macintosh (group ML), Airtraq (group AQ) or Trueview (groupTL) laryngoscope. Laryngoscopic view of glottis (Cormac and Lehane grade), time taken for intubation , subjective assessment for ease of intubation, intubation difficulty scale (IDS) score as well as attempts for successful intubation, success rate and soft tissue injury during laryngoscopy and intubation were compared. Results: All the patients intubated with Airtraq and Trueview had Cormack and Lehane grade I or II and none had grade III in comparison with 42 (84%) having grade I or II and 8(16%) having grade III (p<0.05). Mean time taken for intubation was significantly longer with Truview (35.3±11.5sec) and comparable between Airtraq (19.2±4.7 sec) and Macintosh (24.4±13.8 sec) (p<0.05). On subjective assessment Truview was rated as most difficult device to use for intubation amongst three laryngoscopes. Truview and Airtraq had mean IDS scores of <1 (0.75± 0.4 and 0.56± 0.5 respectively) while a higher score (1.76±2) was found with Macintosh (p<0.05). No significant difference was noted in terms of attempts at intubation, success rate and soft tissue injury. Conclusion: We concluded that Airtraq was a promising and reliable alternative to Macintosh for endotracheal intubation of patients with normal airway characteristics in experienced hands. Although Trueview provided better intubating conditions than Macintosh, it took longer time for intubation and on subjective assessment, it was graded as difficult to use.