A comparison of the effects of different types of laryngoscope on the cervical motions: randomized clinical trial

Abstract

Background: The rate of cervical injury among alltrauma patients is 3.1%. The most important point dur- ing intubation of those patients is not to increase thecervical injury. Aims: In this study, we hypothesize that there will be aminimal cervical extension during a laryngoscopy withthe use of optical view laryngoscopes. Study Design: Prospective, randomized clinicaltrial. Methods: One hundred and fifty adult patients withASA physical status I to III were enrolled in our study.After routine anesthesia induction, we randomly as- signed the patients into three groups according tothe type of laryngoscope. Macintosh type, TruviewEVO2® type and Airtraq® type laryngoscopes wereused in Group DL (n=50), Group TW (n=50) andGroup ATQ (n=50), respectively. After applying gen- eral anesthesia induction and mask ventilation, all ofthe patients were positioned in the neutral position.An inclinometer was placed on the forehead of thepatients. Then, the extension angle during intubation and the Cormack-Lehane Score were measured andthe time to intubation was recorded.Results: One of the 50 patients in the DL Group, 2 of the50 patients in the TW Group, and 4 of the 50 patients inthe ATQ Group were excluded from the study becauseof the failure of intubation at defined times. The angleof cervical extension during laryngoscopy was foundto be 27.24±6.71, 18.08±7.53, and 14.54±4.09 degreesin the Groups DL, TV and ATQ, respectively; thesedifferences also had statistical significance (p=0.000).The duration of intubation was found to be 13.59±5.49,23.60±15.23, and 29.80±13.82 seconds in Groups DL,TV and ATQ, respectively (p=0.000).Conclusion: A minimal cervical motion was obtainedduring tracheal intubation with the use of TruviewEVO2® and Airtraq® types of laryngoscope comparedwith the Macintosh laryngoscope. (ClinicalTrials.govIdentifier: NCT02191904).Keywords: Airtraq®, airway management, intratrachealequipment, intubation, Macintosh, Truview EVO2®