Cervical spine motion: a fluoroscopic comparison of the AirTraq Laryngoscope versus the Macintosh laryngoscope.
BACKGROUND
The optimal technique to intubate the trachea in patients presenting with a potential or documented cervical spine (C-spine) injury remains unresolved. Using continuous fluoroscopic video assessment, C-spine motion during laryngoscopy with an AirTraq Laryngoscope (King Medical Systems, Newark, DE) was compared to that with intubation using a Macintosh blade.


METHODS
Twenty-four healthy surgical patients gave written consent to participate in a crossover randomized controlled trial; all patients were subjected to both Macintosh and AirTraq laryngoscopy with manual inline stabilization after induction of anesthesia. The C-spine motion was examined at four areas: the occiput-C1 junction, C1-C2 junction, C2-C5 motion segment, and C5-thoracic motion segment. The time required for laryngoscopy was also measured.


RESULTS
C-spine motion using the AirTraq was less than that during Macintosh laryngoscopy, averaging 66% less (P < 0.01) at three of the motion segments studied, occiput-C1, C2-C5, and C5-thoracic. There was no difference at the C1-C2 segment. There was no significant difference in the time to accomplish laryngoscopy between the two devices.


CONCLUSIONS
For patients in whom C-spine movement is undesirable, use of the AirTraq Laryngoscope may be useful to limit movement without an increase in the duration of intubation.
Turkstra
Timothy P
TP
Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London, Ontario, Canada. timothy.turkstra@lhsc.on.ca
Pelz
David M
DM
Jones
Philip M
PM
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000502:physiology / Q000601:surgery*; D018592:Cross-Over Studies; D017558:Elective Surgical Procedures / Q000295:instrumentation / Q000379:methods / Q000592:standards; D005260:Female; D005471:Fluoroscopy / Q000379:methods / Q000592:standards; D006801:Humans; D020704:Laryngoscopes / Q000592:standards*; D007828:Laryngoscopy / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D009038:Motion; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery