• Eur J Anaesthesiol · Apr 2013

    Randomized Controlled Trial Comparative Study

    Comparison of the Airtraq and the Macintosh laryngoscope for double-lumen tube intubation: a randomised clinical trial.

    • Simone Wasem, Marc Lazarus, Johannes Hain, Jasmin Festl, Peter Kranke, Norbert Roewer, Markus Lange, and Thorsten M Smul.
    • Department of Anaesthesia and Critical Care, University Hospital of Würzburg, Würzburg, Germany. wasem_s@klinik.uni-wuerzburg.de
    • Eur J Anaesthesiol. 2013 Apr 1; 30 (4): 180-6.

    ContextThe Airtraq is a disposable optical laryngoscope that is available in a double-lumen tube version. Inserting a double-lumen tube is generally more difficult compared to conventional endotracheal intubation, mainly due to its configuration.ObjectiveThe aim of this study was to compare the Airtraq with the Macintosh laryngoscope for intubation with a double-lumen tube in patients undergoing elective thoracic surgery. The main outcome was time needed for successful intubation.DesignProspective, randomised clinical trial.SettingA single centre, University Hospital of Würzburg, Germany, between July 2009 and June 2011.PatientsAfter a scout laryngoscopy with a Macintosh laryngoscope, 60 adult patients were intubated by an anaesthesiologist with either an Airtraq (n = 30) or a Macintosh laryngoscope (n = 30).Main Outcome MeasuresThe time needed for correct intubation, checked by flexible bronchoscopy, was recorded. The intubation difficulty scale (IDS) and Cormack and Lehane grade were noted. Haemodynamic variables and any evidence of oropharyngeal trauma were documented as well as postoperative sore throat, hoarseness and dysphagia.ResultsThe mean time needed for correct intubation was 20.1 ± 16.5 s in the Airtraq group and 17.5 ± 10 s in the Macintosh group (P = 0.86). All intubations in both groups had an IDS less than 4. The Cormack and Lehane grade was I in all 30 patients in the Airtraq group; in the Macintosh group, it was I and II in 17 and 13 patients, respectively. The incidence of hoarseness was significantly higher in the Airtraq group 24 h postoperatively (P = 0.01).ConclusionThere was no significant difference between the Airtraq and the Macintosh laryngoscopes regarding the time needed to insert a double-lumen tube during elective thoracic surgery. Only subtle enhancement of visualisation and a higher incidence of hoarseness were observed in the Airtraq group. The Airtraq device did not result in superior patient safety in this setting.

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