Comparative evaluation of Airtraq™ optical Laryngoscope and Miller's blade in paediatric patients undergoing elective surgery requiring tracheal intubation: A randomized, controlled trial

Background and Aims: The Airtraq (TM) optical laryngoscope is the only marketed videolaryngoscope for paediatric patients besides the fibre-optic bronchoscope. We hypothesized that intubation would be easier with Airtraq (TM) compared to Miller blade. Hence, we compared Airtraq (TM) with the Miller laryngoscope as intubation devices in paediatric patients. Methods: This prospective, randomized study was conducted in a tertiary care teaching hospital. Sixty children belonging to American Society of Anesthesiologists' Grade I-II, aged 2-10 years, posted for routine surgery requiring tracheal intubation were randomly allocated to undergo intubation using a Miller (n = 30) or Airtraq (TM) (n = 30) laryngoscope. The primary outcome measure was time of intubation. We also measured ease of intubation, number of attempts, percentage of glottic opening score (POGO), haemodynamic changes and airway trauma. Student t test was used to analyse parametric data. Results: Intubation time was comparable between Miller's laryngoscope (15.13 +/- 1.33s) compared to Airtraq (TM) (11.53 +/- 0.49 s) (P = 0.29) The number of first and second attempts at intubation were 25 and 5 for the Miller laryngoscope and 29 and 1 for the Airtraq (TM). Median visual analogue score (VAS) for ease of intubation was 5 in Miller group compared to 3 in Airtraq (TM) group. The median POGO score was 75 in the Miller group and 100 in the Airtraq (TM) group (P = 0.01). Haemodynamic changes were maximum and most significant immediately and 1 min after intubation. Airway trauma occurred in three patients (9.09%) in Miller group and one patient (3.33%) in Airtraq (TM) group. Conclusion: The Airtraq (TM) reduced the difficulty of tracheal intubation and degree of haemodynamic stimulation compared to the Miller laryngoscope in paediatric patients.