Comparative evaluation of ease of tracheal intubation using Airtraq and intubating laryngeal mask airway with cervical spine immobilization

Abstract

Tracheal intubation in cervical spine injury patients with application of Manual In Line Stabilization (MILS) of the cervical spine in neutral position is a challenge for the anesthesiologist since it makes visualization of the larynx more difficult using conventional laryngoscopy. Our study was conducted to compare ease of intubation using Airtraq and Intubating laryngeal mask airway(ILMA) in simulated cervical spine injury patient using MILS. 100 ASA I/II patients (without cervical spine injury), aged 18-60 years were randomly allocated in two groups -Group A: Airtraq (n=50), Group I: ILMA (n=50). General anaesthesia was given as per standard protocol in all the patients, after that MILS was applied and patients intubated using Airtraq in group A and ILMA in group I with neck in neutral position. Time taken for intubation, number of attempts for intubation, ease of intubation with Airtraq/ILMA, hemodynamics and complications were compared.The mean time taken for intubation in the Group A was 12.6 ± 6.6 seconds and in the Group, I was 85.8 ± 36.6 seconds (p<0.001). Number of intubations attempts in Group A was significantly less as compared to the Group I (p= 0.027).Airtraq is a safer and faster alternative when compared to ILMA in patients with simulated cervical spine injury using manual in line stabilization.