Learning curves of the Airtraq and the Macintosh laryngoscopes for tracheal intubation by novice laryngoscopists: a clinical study.
BACKGROUND
The curved laryngoscope blade described by Macintosh in 1943 remains the most widely used device to facilitate tracheal intubation. The Airtraq laryngoscope is a new, single-use device for tracheal intubation. Several studies compared the use of Airtraq and Macintosh laryngoscopes in simulated intubation scenarios on manikins. We evaluated learning and performance of tracheal intubation by novice laryngoscopists using the Airtraq or Macintosh laryngoscopes in a randomized controlled clinical trial.


METHODS
One hundred eight consecutive patients scheduled for surgical procedures requiring tracheal intubation were enrolled. Patients were randomly allocated to undergo tracheal intubation using a Macintosh (n = 54) or an Airtraq (n = 54) laryngoscope. Tracheal intubation was performed by first-year residents who had no prior experience with the use of either laryngoscope. Primary end points were duration of tracheal intubation and intubation difficulty scale score for both devices.


RESULTS
Eighteen residents participated in the protocol; 9 were allocated to each study group. Each participant performed at least 6 tracheal intubations with the same device. We observed a more rapid skill acquisition with the Airtraq than with the Macintosh laryngoscope, as demonstrated by the shorter duration of intubation with the Airtraq laryngoscope. Data analysis with the Student t test revealed a significant difference between the groups (P < 0.001).


CONCLUSIONS
The Airtraq laryngoscope facilitates a more rapid learning curve compared with the Macintosh laryngoscope when used in a clinical setting by novice laryngoscopists. The Airtraq laryngoscope was judged easier to use by novice users.
Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Via Renzo da Ceri, 87 00176 Rome, Italy. pierangelo.dimarco@uniroma1.it
Pierangelo
P
Di Marco
Lorena
L
Scattoni
Annamaria
A
Spinoglio
Marta
M
Luzi
Alessandra
A
Canneti
Paolo
P
Pietropaoli
Carlo
C
Reale
D002983:Clinical Competence / Q000592:standards; D004867:Equipment Design; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000592:standards; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods*; D020704:Laryngoscopes / Q000592:standards; D059032:Learning Curve; D013997:Time Factors