A Study to Compare the Efficacy of Intubation with Oral Versus Nasal Airtraq using Preformed Tracheal Tube in Patients Undergoing Cleft Lip and Palate Repair

Preformed Ring, Adair and Elwyn (RAE) tracheal tubes are generally preferred for tracheal intubation in patients undergoing cleft lip and palate repair. Till date, only few sporadic cases in literature have been reported where oral Airtraq optical laryngoscope has been used to perform tracheal intubation with RAE tracheal tube in these children. In this study we hypothesize that using a pre shaped styleted RAE endotracheal tube with nasal Airtraq (without a side channel) would be easier to direct the tracheal tube towards the glottis than with an oral Airtraq resulting in reduced intubation time and increased success rate. Following approval by Hospital Ethical Issues committee, 30 ASA I and II patients between 1-24 months of age with cleft lip and palate undergoing repair of either cleft lip or palate were included in this study. Patients were randomized into two groups of 15 patients each as per sealed envelope. Tracheal intubation was performed by senior anesthetists who were well experienced in visualizing the glottic view on its dedicated video screen and intubation with oral or nasal Airtraq. Mean time to perform tracheal intubation using Nasal Airtraq was over 50% faster than when using Oral Airtraq. Nasal Airtraq ensures 100% successful intubation in the first attempt as compared to 60% with Oral Airtraq. In conclusion, Nasal Airtraq aided tracheal intubation is superior to Oral Airtraq in patients with cleft lip and palate that gives nearly 100% successful tracheal intubation in the first attempt with no evidence of soft tissue trauma.