Endotracheal Intubation Comparing Airtraq and McCoy Laryngoscope in Patients with Simulated Cervical Spine Immobilization

Objectives: Sniffing position for laryngoscopy requires flexion of the lower and extension of upper cervical spine and atlanto-occipital joint. Laryngoscopy is challenging in cervical spine pathology. This study was conducted to compare Airtraq with McCoy for ease of intubation in patients with simulated cervical immobilization. Materials and Methods: One hundred patients belonging to the American Society of Anaesthesiologists I–III of 20–60 years requiring intubation were randomly allocated into two groups – Group A (Airtraq) and Group M (McCoy laryngoscope). Philadelphia collar was applied in all patients before induction of anesthesia. Parameters observed were the number of attempts for intubation, intubation time, glottic view, intubation difficulty score (IDS), success rate, and hemodynamic changes. Results: Demographic profiles were comparable. First-attempt success was higher in Group A. Mean intubation time was higher in Group M ( P < 0.001). CL Grade 1, 2a, 2b, and 3a in Group A was 66%, 26%, 8%, and 0%, respectively, in Group M was 34%, 48%, 12%, and 6%, respectively ( P = 0.008). The percentage of glottic opening score was higher in Group A ( P < 0.001). IDS was better in Group A ( P < 0.001). Conclusion: Both Airtraq and McCoy laryngoscope offer high success rates in simulated difficult airways. However, Airtraq provides improved ease of intubation, better glottic view, and lesser hemodynamic alterations as compared to McCoy laryngoscope.