Split Type Postman videolaryngoscope: The newer device versus the standard Macintosh laryngoscope in simulated difficult airway – A new hope for difficult intubation scenarios

BACKGROUND AND AIMS: Studies on simulated difficult airway provide an opportunity to evaluate the performance of intubation devices for use in limited neck mobility. We did a comparative study between Split Type Postman videolaryngoscope and Macintosh laryngoscope, evaluating their efficacy for tracheal intubation in a simulated difficult airway. METHODS: Sixty American Society of Anesthesiologists (ASA) physical status I and II patients aged between 20 and 60 years, having body mass index <30 kg m(−2), posted for elective surgery under general anaesthesia were allocated to two groups. Endotracheal intubation was done with either Split Type Postman videolaryngoscope or Macintosh laryngoscope after placing a rigid cervical collar around the neck to simulate a difficult airway. The primary outcome measure was time for tracheal intubation as assessed from the time of introduction of laryngoscope between incisors till visual confirmation of passage of endotracheal tube through the vocal cords by the anaesthesiologist. Success rate of intubation, number of attempts required for successful intubation, haemodynamic alterations and airway complications were measured as secondary outcomes. RESULTS: Time taken for endotracheal intubation was significantly shorter in Postman group (26.23 ± 7.18 vs. 31.43 ± 9.83 s) (P = 0.012) compared to Macintosh group. The groups were comparable in terms of incidence (P = 0.491) of successful intubation, with significantly lesser number of attempts required for intubation in Postman group (P = 0.022). The incidence of airway trauma and postoperative sore throat was comparable between the groups. CONCLUSION: Split Type Postman videolaryngoscope was superior with respect to intubation characteristics when compared to conventional laryngoscope.