title: [Comparison between the Airtraq, X-Lite, and direct laryngoscopes for thyroid surgery: a randomized clinical trial].
abstract: OBJECTIVE
  To compare the performance of the Airtraq, X-Lite, and direct laryngoscopes for tracheal intubation for elective thyroid surgery.
  
  
  METHODS
  In this randomized prospective study, Patients who were ASA (American Society of Anesthesiologists) I or II physical status I or II and patients undergoing thyroid surgery were included in this randomized prospective study. Patients with attributes for difficult intubation criteria were excluded. After induction of anesthesia with fentanyl, propofol, and cisatracurium, patients were randomized into three groups according to the intubating device used: Airtraq laryngoscope (Airtraq), X-Lite video laryngoscope (X-lLite), and direct laryngoscope with a Macintosh blade (Direct). The primary outcome measurement was the time needed for tracheal intubation. Secondary outcomes included intubation difficulty score (IDS), Cormack-Lehane classification, as well as hemodynamic and respiratory effects.
  
  
  RESULTS
  One hundred and five patients were included. Mean (standard deviation) time for intubation was 28.2 (2.1) sec in the Airtraq group vs 36.6 (3.7) sec in the X-Lite group (P < 0.001), and 41.1 (4.4) sec in the Direct group (P < 0.001). Compared with to the direct laryngoscope, the Airtraq provided better visualization of the glottis (P = 0.003) with fewer attempts (P < 0.001) and lower IDS (P < 0.001). The intubation difficulty score was lower with the Airtraq than with the X-Lite (P = 0.003). Patients in the X-Lite and Direct groups showed more hemodynamic variations than those in the Airtraq group. There was only one failed intubation, in the direct group.
  
  
  CONCLUSIONS
  In thyroid surgery, the Airtraq and X-Lite laryngoscopes decrease time to intubation when compared with direct laryngoscopy.
authors.affiliation: Pôle d'Anesthésie-Réanimation, Hôpital Militaire Med V, Rabat Agdal, Rabat, Maroc. mustaphabens_15rea@hotmail.com
authors.forename: Mustapha
authors.initials: M
authors.lastname: Bensghir
authors.forename: Chakib
authors.initials: C
authors.lastname: Chouikh
authors.forename: Najib
authors.initials: N
authors.lastname: Bouhabba
authors.forename: Salaheddine
authors.initials: S
authors.lastname: Fjjouji
authors.forename: Jalal
authors.initials: J
authors.lastname: Kasouati
authors.forename: Hicham
authors.initials: H
authors.lastname: Azendour
authors.forename: Noredine Drissi
authors.initials: ND
authors.lastname: Kamili
mesh_terms: D000328:Adult; D005260:Female; D005931:Glottis; D006439:Hemodynamics; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013959:Thyroid Diseases / Q000601:surgery*; D013997:Time Factors