Tracheal intubation in patients with cervical spine immobilization: a comparison of the airwayscope®, lma ctrach®, and the macintosh laryngoscopes
Malik, M. A. Subramaniam, R. Churasia, S. Maharaj, C. H. Harte, B. H. Laffey, J. G.
Malik, M. A.
Subramaniam, R.
Churasia, S.
Maharaj, C. H.
Harte, B. H.
Laffey, J. G.
Repository DOI
Publication Date
2009-03-31
Keywords
equipment, aws (r) laryngoscope, equipment, macintosh laryngoscope, difficult intubation, intubation, tracheal, lma ctrach (r), neck immobilization, creutzfeldt-jakob-disease, morbidly obese-patients, closed claims analysis, endotracheal intubation, mccoy laryngoscope, randomized-trial, truview evo2(r), difficult, airway, management
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Article
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Citation
Malik, M. A. Subramaniam, R.; Churasia, S.; Maharaj, C. H.; Harte, B. H.; Laffey, J. G. (2009). Tracheal intubation in patients with cervical spine immobilization: a comparison of the airwayscope®, lma ctrach®, and the macintosh laryngoscopes. BJA: British Journal of Anaesthesia 102 (5), 654-661
Abstract
The purpose of this study was to evaluate the effectiveness of the Pentax AWS (R), and the LMA CTrach (R), in comparison with the Macintosh laryngoscope, when performing tracheal intubation in patients with neck immobilization using manual in-line axial cervical spine stabilization. Ninety patients undergoing anaesthesia who required tracheal intubation were randomly assigned to undergo intubation using a Macintosh (n=30), LMA CTrach (R) (n=30), or AWS (R) (n=30) laryngoscope. All patients were intubated by one of the three anaesthetists familiar with the use of each laryngoscope. The intubation difficulty scores were significantly higher with the Macintosh laryngoscope and were significantly lower with the AWS (R) compared with the LMA CTrach. All 30 patients were successfully intubated with the Macintosh and the AWS (R) device, compared with 27 patients with the LMA CTrach (R). The duration of both the first and the successful tracheal intubation attempts was significantly longer with the LMA CTrach (R) compared with the AWS (R) and Macintosh laryngoscopes. A greater number of optimization manoeuvres were required to facilitate tracheal intubation with the LMA CTrach (R) compared with the AWS (R) laryngoscope. The AWS (R) group had a significantly better Cormack and Lehane glottic view obtained at laryngoscopy compared with both other devices. The AWS (R) laryngoscope has several advantages over the Macintosh laryngoscope, or LMA CTrach (R), in patients undergoing cervical spine immobilization.
Funder
Publisher
Oxford University Press (OUP)
Publisher DOI
10.1093/bja/aep056
Rights
Attribution-NonCommercial-NoDerivs 3.0 Ireland