Comparison of haemodynamic responses to tracheal intubation using macintosh and airtraq® laryngoscope in patients with simulated cervical spine injury

Background: Mechanical stimulation of airway structures occurs during laryngoscopy. The magnitude of cardiovascular response is related to the force and duration of laryngoscopy. Video laryngoscopes like Airtraq® will help us to intubate patients with restricted neck movements without much manipulation but are bulkier than conventional Macintosh laryngoscope. We compared Airtraq® and Macintosh laryngoscopes in patients with simulated cervical spine injury with respect to haemodynamic fluctuations. Methodology: A prospective, randomized study involving patients who are undergoing elective surgical procedures under GA. After routine preoperative preparation and monitoring, patients were administered conventional general anaesthesia. Preloaded Airtraq® or Macintosh laryngoscope was used for intubation. The outcome variables of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded at regular intervals. Duration for intubation, manoeuvers required to optimize laryngeal view, glottic view, number of attempts taken and complications if any, were noted down as secondary objectives. Results: We observed that there is no significant difference in the average of variation in HR (p=0.078), SBP (p=0.515) and MAP (p=0.057) from the baseline between the two groups. We performed independent sample t test to know whether there is any significant difference for average duration of intubation, glottic view, ease of intubation and complications and we observed that there is significant difference in average duration of intubation (p=0.002) between two groups. Conclusion: Haemodynamic response caused by intubation with Airtraq® and Macintosh laryngoscopes in simulated cervical spine injury were comparable.