Comparison of the C-MAC®, Airtraq®, and Macintosh laryngoscopes in patients undergoing tracheal intubation with cervical spine immobilization

Background We aimed at comparing the performance of the C-MAC®, Airtraq®, and Macintosh laryngoscopes when performing tracheal intubation in patients undergoing neck immobilization using manual inline axial cervical spine stabilization. Methods Ninety consenting patients presenting for surgery requiring tracheal intubation were randomly assigned to undergo intubation using a C-MAC® (n30), Airtraq® (n29), or Macintosh (n31) laryngoscope. All patients were intubated by one anaesthetist experienced in the use of each laryngoscope. Results The Airtraq® laryngoscope performed best in these patients, reducing the Intubation Difficulty Scale score, improving the Cormack and Lehane glottic view, and reducing the need for optimization manoeuvres, compared with both the Macintosh and the C-MAC®. The C-MAC® and Macintosh laryngoscopes performed similarly. There were no differences in success rates or haemodynamic profiles post-intubation between any of the devices tested. Conclusions The Airtraq® laryngoscope performed better than the C-MAC® and Macintosh laryngoscopes in patients undergoing cervical immobilization.