Authors : Arjun Haridas, Raghavendra Babu T, Gurudatt C L
DOI : 10.18231/j.ijca.2020.012
Volume : 7
Issue : 1
Year : 2020
Page No : 64-70
Introduction and Aims: Laryngoscopy in patients with suspected neck injuries has one goal: sufficient
laryngeal exposure with least cervical spine movement. This is achieved by either Manual In-line
Stabilisation (MILS), a forehead tape or rigid cervical collars. Cervical collars reduce movements of spine
and also mouth opening leading to difficult direct laryngoscopy. This is due to difficulty in aligning the oropharyngo-
laryngeal axes. The laryngoscope giving best glottic view with least cervical spine movement in
the shortest time would be most ideal. We intend to compare Airtraq, McCoy and Macintosh laryngoscopes
in terms of intubation time and Cormack-Lehane glottic view in patients undergoing elective surgeries with
simulated neck immobilization using rigid cervical collar.
Materials and Methods: Following approval from Institutional Ethical Committee, 90 consenting
patients, aged 18-65years were assigned into three groups by random sampling (Serially numbered Opaque
Sealed Envelope), namely Group A (Airtraq), M (McCoy) or C (Macintosh). Intubation time, Intubation
difficulty scale (IDS) and Modified Cormack-Lehane grading were noted.
Results: Mean intubation time was 27.2sec( 6.47), 40.2sec ( 12.36) and 33.10sec ( 23.05) for Airtraq,
McCoy and Macintosh respectively(p-value 0.00 7). IDS values were 0,3 and 2 respectively(P< 0> Cormack Lehane glottic view was 2 for Macintosh and McCoy and 1 for Airtraq, respectively (P< 0> Conclusion: Airtraq improves ease of intubation significantly when compared to McCoy and Macintosh
blade with shorter intubation time and IDS Score, in patients with simulated difficult airway using neck
immobilization.
Keywords: Airtraq, McCoy, Macintosh, Rigid cervical collar, Simulated difficult airway.