Alternative Airway Means for Endotracheal Intubation in Adult Patients for Cervical Discectomy. Comparison between Airtraq, King Vision Video Laryngoscope and Macintosh Laryngoscope: A Prospective Randomized Study

Abstract

Objectives: A prospective randomized study to demonstrate the ease of intubation between Airtraq, King Vision video laryngoscope, and Macintosh laryngoscope, to compare the different laryngeal views and the need for assisted maneuvers, and hemodynamic changes during intubation in patients scheduled for one level cervical discectomy. Materials & Methods: Ninety patients ASA I&II scheduled for one level cervical discectomy were randomly assigned into three groups to perform endotracheal intubation with Airtraq (group I; 30 patients), King Vision laryngoscope (group II; 30 patients), and Macintosh laryngoscope (group III; 30 patients). Intubation time and success rate for intubation were recorded. Also, observation and recording of vocal cord visualization using Cormack-Lehane grading and intubation difficulty score (IDS), complications and hemodynamic changes occurred with each aid. Results: There were statistically significant differences between the three groups as regard the time needed for successful intubation, the need for assist maneuvers, quality of glottis view, and the incidence of complications during airways manipulations, with better results (less time taken for intubation, better glottis view, less IDS and less complications with more stable hemodynamics during intubation) for king Vision group compared with Airtraq and Macintosh laryngoscope groups. Conclusion: King Vision laryngoscope had advantages of short time for intubation, almost, no complications occurred with it contrary to Airtraq or Macintosh laryngoscope and almost, no significant alterations in hemodynamics during intubation. It might give self-confidence to the anesthesiologist to use it easily, ensures intubation and permits many assistant doctors or trained residents to visualize the field during intubation.