title: Easy and difficult nasal intubation--a randomised comparison of Macintosh vs Airtraq® laryngoscopes.
abstract: A new Airtraq(®) laryngoscope has been developed for nasal intubation. We prospectively compared tracheal intubation efficiency of the Airtraq for nasotracheal intubation vs that of the Macintosh laryngoscope in 200 patients. Depending on pre-operative airway evaluation, the patients were allocated to expected easy (n = 100) or difficult (n = 100) intubation groups, on the basis of mouth opening ≤ 2.5 cm, modified Mallampati score of 4, history of difficult intubation, obvious tumour or swelling. Patients were randomly allocated to the Macintosh or nasotracheal Airtraq technique. All easy intubations were successfully performed with the respective technique. In the expected difficult intubation group, the success rate was higher (47/50 vs 33/50; p < 0.01), the glottis view was better (Cormack and Lehane 1/2/3/4 grades: 29/17/1/3 vs 5/11/18/16, p < 0.01), mean (SD) intubation time was shorter (45(46) s vs 77(47)s, p < 0.01) and the number of optimising manoeuvres was reduced with the nasotracheal Airtraq compared with the Macintosh, respectively. For difficult nasal intubations, the nasotracheal Airtraq is more effective than the Macintosh laryngoscope.
authors.affiliation: Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Kliniken Essen-Mitte, Essen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: St Mont
authors.forename: I
authors.initials: I
authors.lastname: Biesler
authors.forename: R
authors.initials: R
authors.lastname: Pförtner
authors.forename: C
authors.initials: C
authors.lastname: Mohr
authors.forename: H
authors.initials: H
authors.lastname: Groeben
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia; D000777:Anesthetics / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D020704:Laryngoscopes / Q000009:adverse effects; D007828:Laryngoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D012307:Risk Factors; D013515:Surgery, Oral; D014132:Trachea / Q000033:anatomy & histology; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000777:Anesthetics