Comparison of Intubation Conditions Between Airtraq, McGrath Video Laryngoscopes, and Macintosh Under Conditions of Simulated Trauma Airway and Rapid Sequence Induction Intubation

Background: Patients arriving at the emer-gency department with a potential cervical spine injury and immobilized in a rigid cervical collar often require emer-gency airway management and rapid sequence induction intubation (RSII). There have been several advances in air-way management with the advent of channeled (Airtraq((R)) Prodol Meditec) and nonchanneled (McGrath((R)) Meditron-ics) video laryngoscopes, which enable intubation without the removal of the cervical collar, but their efficacy and superiority over conventional laryngoscopy (Macintosh) in the presence of a rigid cervical collar and cricoid pres-sure have not been evaluated. Objective: Our aim was to compare the channeled (Airtraq [group A]) and nonchan-neled (McGrath [Group M]) video laryngoscopes with a conventional laryngoscope (Macintosh [Group C]) in a sim-ulated trauma airway. Methods: A prospective randomized controlled study was conducted in a tertiary care center. Participants were 300 patients requiring general anesthesia (American Society of Anesthesiologists class I or II), of both sexes, and aged 18-60 years. Airway management was sim-ulated without removal of a rigid cervical collar and using cricoid pressure during intubation. After RSI, patients were intubated with one of the study techniques according to ran-domization. Intubation time and intubation difficulty scale (IDS) score were noted. Results: Mean intubation time was 42.2 s in group C, 35.7 s in group M, and 21.8 s in group A (p = 0.001). Intubation was easy in group M and group A (median IDS score of 0; interquartile range [IQR] 0-1 for group M and median IDS score of 1; IQR 0-2 for group A and group C;p < 0.001). A higher proportion (95.1%) of pa-tients had an IDS score of < 1 in group A. Conclusions: The performance of RSII with cricoid pressure in the presence of a cervical collar was easier and more rapid with channeled video laryngoscope than with other techniques. (c) 2022 Else-vier Inc. All rights reserved.