Comparison of Three Laryngoscopes in Difficult Laryngoscopy

Government Medical College, Haldwani

Status: Completed

Conditions: Intubation; Difficult

Treatments: Device: Intubation- Airtraq laryngoscope; Device: Intubation- MacCoy laryngoscope; Device: Intubation- Macintosh laryngoscope

Study type: Interventional

Funder types: Other

Identifiers

NCT02387502

123-IEC/01/13

Details and patient eligibility

About

Tracheal intubation requires alignment of oro-pharyngeal-laryngeal axes. When these three axes are not aligned, intubation becomes difficult. In the researchers' study, the investigators simulated difficult laryngoscopy situation by using a rigid neck collar. This neck collar renders intubation difficult not only by restricting neck movement, but also reducing mouth opening. The investigators compared the performance of Macintosh, MacCoy and Airtraq laryngoscope in simulated difficult laryngoscopy using a rigid neck collar.

Full description

Airtraq laryngoscope is an optical laryngoscope which allows visualization of vocal cord as a reflected image through multiple lenses and prisms. MacCoy laryngoscope is a modification of Macintosh laryngoscope. It has a lever which, when pressed, moves its flexible tip. In the investigators' study, the researchers compared the performances of Airtraq laryngoscope with MacCoy and Macintosh laryngoscopes in simulated difficult laryngoscopy using a rigid neck collar. The researchers recruited 120 patients and randomly divided those patients into three equal groups i.e. 30 patients in each group. These three groups are 1-Airtraq, 2-MacCoy and 3-Macintosh. The researchers compared efficacy and safety in these three laryngoscopes. The researchers compared efficacy in terms of time of intubation, ease of intubation, overall success, Intubation difficulty score, visualization of vocal cord in terms of POGO (percentage of Glottic Opening) score. The researchers compared safety in terms of hemodynamic pressor response and airway trauma.

Enrollment: 120 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists (ASA) physical status I and II.
• Posted for elective surgery requiring general anesthesia and tracheal intubation

Exclusion criteria

• patients with anticipated difficult airway
• obese (body mass index (BMI)>30) patients
• patients with risk of pulmonary aspiration of gastric contents
• pregnant patients
• patients with airway distortion or trauma.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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120 participants in 3 patient groups

Intubation with Macintosh laryngoscope

Experimental group

Description:

40 patients were intubated with Macintosh laryngoscope after simulating difficult laryngoscopy using rigid neck collar.

Treatment:

Device: Intubation- Macintosh laryngoscope

Intubation with MacCoy laryngoscope

Active Comparator group

Description:

40 patients were intubated with MacCoy laryngoscope after simulating difficult laryngoscopy using rigid neck collar.

Treatment:

Device: Intubation- MacCoy laryngoscope

Intubation with Airtraq laryngoscope

Active Comparator group

Description:

40 patients were intubated with Airtraq laryngoscope after simulating difficult laryngoscopy using rigid neck collar.

Treatment:

Device: Intubation- Airtraq laryngoscope