Abstract
BackgroundTracheal 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.MethodsTwenty-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.ResultsIntubation 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.ConclusionsAirtraq laryngoscope is easier to master for novice personnel with a higher intubation success rate and shorter intubation duration compared with the Macintosh laryngoscope.Trial registrationTrial registration number is ChiCTR-TRC-13003987, approval date Dec 12, 2013.
Highlights
Tracheal intubation with Macintosh laryngoscope is taught to medical students as it is a lifesaving procedure
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, but only in 32% of patients in the Macintosh group (P
Summary
Tracheal intubation with Macintosh laryngoscope is taught to medical students as it is a lifesaving procedure. 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. The Airtraq optical laryngoscope is a relatively new, single-use device for tracheal intubation. The curvature of the Airtraq blade and the special internal arrangement of the optical components allow visualization of the glottic plane without alignment of the oral, pharyngeal, and tracheal axes, which may facilitate an easier glottis exposure (Figure 1). Several studies revealed the advantages of Airtraq over Macintosh laryngoscopes in simulated intubation scenarios on manikins [4] and in clinical trials [5]. Teaching medical students how to intubate with both devices has not been studied
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
