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A Randomized Comparative Study Between Airtraq and McCoy for Intubation in Patients with Cervical Spine Injury


Affiliations
1 Department of Anaesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
2 Department of Anaesthesia, Medanta, Gurgaon, Haryana, India
 

Background: This study was done to compare Airtraq and McCoy for intubation characteristics and hemodynamic parameters following endotracheal intubation in patients undergoing anterior cervical discectomy and fusion (ACDF) surgery. Materials and Methods: After Institutional Ethical Committee approval, a prospective randomized comparative study was designed on forty American Society of Anesthesiologists I and II patients involving single level ACDF surgery. Following standard anesthesia protocol and manual in-line stabilization applied along with a cervical collar or pin traction for immobilization, tracheal intubation was performed either with Airtraq or McCoy. The time taken for intubation, intubation difficulty score (IDS), comfort grading, and hemodynamic parameters were noted following intubation. The categorical data were compared using Chi-square test and the continuous variables were compared between the groups using paired sample t-test. Repeated ANOVA was tested for hemodynamic data at each measurement time point and Tukey post hoc was used for within the group comparisons at different timings following intubation. Results: The mean intubation time was 24.41 ± 14.8 s in Airtraq group (Group A) which was statistically significant compared to McCoy group (Group M) 38.96 ± 15.55 s (P = 0.001). The IDS and comfort grading was statistically significant in Group A compared to Group M. The changes in hemodynamic vitals following intubation were comparable in both the groups. Conclusion: Airtraq improves the grade of glottic visualization with minimal assistance. It also minimized the time taken for intubation had stable hemodynamics with increased comfort to the anesthetist.

Keywords

Airtraq, cervical spine injury, immobilization, McCoy laryngoscope
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  • A Randomized Comparative Study Between Airtraq and McCoy for Intubation in Patients with Cervical Spine Injury

Abstract Views: 165  |  PDF Views: 89

Authors

Srilata Moningi
Department of Anaesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
Dilip Kumar Kulkarni
Department of Anaesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
Gopinath Ramachandran
Department of Anaesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
Anandram Aluri
Department of Anaesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
Sudheer Kumar Atluri
Department of Anaesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
Anshul Yadav
Department of Anaesthesia, Medanta, Gurgaon, Haryana, India

Abstract


Background: This study was done to compare Airtraq and McCoy for intubation characteristics and hemodynamic parameters following endotracheal intubation in patients undergoing anterior cervical discectomy and fusion (ACDF) surgery. Materials and Methods: After Institutional Ethical Committee approval, a prospective randomized comparative study was designed on forty American Society of Anesthesiologists I and II patients involving single level ACDF surgery. Following standard anesthesia protocol and manual in-line stabilization applied along with a cervical collar or pin traction for immobilization, tracheal intubation was performed either with Airtraq or McCoy. The time taken for intubation, intubation difficulty score (IDS), comfort grading, and hemodynamic parameters were noted following intubation. The categorical data were compared using Chi-square test and the continuous variables were compared between the groups using paired sample t-test. Repeated ANOVA was tested for hemodynamic data at each measurement time point and Tukey post hoc was used for within the group comparisons at different timings following intubation. Results: The mean intubation time was 24.41 ± 14.8 s in Airtraq group (Group A) which was statistically significant compared to McCoy group (Group M) 38.96 ± 15.55 s (P = 0.001). The IDS and comfort grading was statistically significant in Group A compared to Group M. The changes in hemodynamic vitals following intubation were comparable in both the groups. Conclusion: Airtraq improves the grade of glottic visualization with minimal assistance. It also minimized the time taken for intubation had stable hemodynamics with increased comfort to the anesthetist.

Keywords


Airtraq, cervical spine injury, immobilization, McCoy laryngoscope