Airtraq™ versus Macintoch laryngoscope in intubation performance in the pediatric population

PURPOSE: Airtraq™ is an optical laryngoscope that allows viewing of the vocal cords without a direct line of sight. The main objective of this prospective, randomized, controlled trial was to evaluate Airtraq intubation characteristics, mainly intubation time and cardiovascular changes in the pediatric patients. METHODS: Fifty children of American Society of Anesthesiologists class I, 2-10 years of age were divided into 2 groups using sealed envelope technique. Children were premedicated with midazolam. Anesthesia was induced with sevoflurane, fentanyl, and atracurium. Patients were randomly allocated to be intubated with either Airtraq (Airtraq group) or Macintosh laryngoscope (Macintosh group). Intubation time, number of intubation attempts, optimization maneuvers, and ease of intubation were recorded. Hemodynamic variables were recorded before and after anesthetic induction, 1, 3, and 5 min after tracheal intubation. RESULTS: The mean age of children was 6.1 years. Compared with Macintosh group, the use of Airtraq was associated with shorter intubation time (51.6±26.7 s vs 22.8±6.1 s, respectively, P=0.001), less median number of intubation attempts 2 (1-2) versus 1 (1-1), P=0.001), more ease of intubation [2 (1-3) versus 1 (1-1), P=0.001] and less increase in the heart rate 5 min after intubation (P=0.007). No optimization maneuvers required for Airtraq laryngoscope (P=0.001). CONCLUSION: Airtraq decreases intubation time, number of attempts, and optimization maneuvers, less heart rate changes during intubation compared with Macintosh laryngoscope.