title: Comparison of the Airtraq and the Macintosh laryngoscope for double-lumen tube intubation: a randomised clinical trial.
abstract: BACKGROUND
  The Airtraq is a disposable optical laryngoscope that is available in a double-lumen tube version. Inserting a double-lumen tube is generally more difficult compared to conventional endotracheal intubation, mainly due to its configuration.
  
  
  OBJECTIVE
  The aim of this study was to compare the Airtraq with the Macintosh laryngoscope for intubation with a double-lumen tube in patients undergoing elective thoracic surgery. The main outcome was time needed for successful intubation.
  
  
  METHODS
  Prospective, randomised clinical trial.
  
  
  METHODS
  A single centre, University Hospital of Würzburg, Germany, between July 2009 and June 2011.
  
  
  METHODS
  After a scout laryngoscopy with a Macintosh laryngoscope, 60 adult patients were intubated by an anaesthesiologist with either an Airtraq (n = 30) or a Macintosh laryngoscope (n = 30).
  
  
  METHODS
  The time needed for correct intubation, checked by flexible bronchoscopy, was recorded. The intubation difficulty scale (IDS) and Cormack and Lehane grade were noted. Haemodynamic variables and any evidence of oropharyngeal trauma were documented as well as postoperative sore throat, hoarseness and dysphagia.
  
  
  RESULTS
  The mean time needed for correct intubation was 20.1 ± 16.5 s in the Airtraq group and 17.5 ± 10 s in the Macintosh group (P = 0.86). All intubations in both groups had an IDS less than 4. The Cormack and Lehane grade was I in all 30 patients in the Airtraq group; in the Macintosh group, it was I and II in 17 and 13 patients, respectively. The incidence of hoarseness was significantly higher in the Airtraq group 24 h postoperatively (P = 0.01).
  
  
  CONCLUSIONS
  There was no significant difference between the Airtraq and the Macintosh laryngoscopes regarding the time needed to insert a double-lumen tube during elective thoracic surgery. Only subtle enhancement of visualisation and a higher incidence of hoarseness were observed in the Airtraq group. The Airtraq device did not result in superior patient safety in this setting.
authors: Department of Anaesthesia and Critical Care, University Hospital of Würzburg, Würzburg, Germany. wasem_s@klinik.uni-wuerzburg.de
authors: Simone
authors: S
authors: Wasem
authors: Marc
authors: M
authors: Lazarus
authors: Johannes
authors: J
authors: Hain
authors: Jasmin
authors: J
authors: Festl
authors: Peter
authors: P
authors: Kranke
authors: Norbert
authors: N
authors: Roewer
authors: Markus
authors: M
authors: Lange
authors: Thorsten M
authors: TM
authors: Smul
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017558:Elective Surgical Procedures; D005260:Female; D005858:Germany; D006685:Hoarseness / Q000453:epidemiology / Q000209:etiology; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019616:Thoracic Surgical Procedures / Q000379:methods; D013997:Time Factors; D055815:Young Adult