ABSTRACT: Airway management remains vital skill for anesthetist. Through history, many devices have been introduced to ease the burden of this crucial technique. This study evaluate and compare conventional Macintosh laryngoscope,considered gold standard since 1940\'s with MacCoy and novel optical Airtraq laryngoscope with respect to ease of intubation,laryngoscopic view,impact on haemodynamic parameters.

METHODS : 90 patients(18-60 yr) with ASA I-II ; Mallampatti class I-II ,scheduled for various surgeries at S.Nijalingappa Medical College,Bagalkot ,under general anesthesia were enrolled in this prospective randomised controlled trial. All patients were subjected to same anesthetic protocol.Patients were randomised into 3 groups of 30 patients each. Group A,B and C were intubated using Macintosh, Maccoy and Airtraq laryngoscope respectively by anesthetist experienced in the use of all 3 laryngoscopes. Ease of intubation based on Intubation difficulty scale(IDS) score,Cormack- Lehane grade at laryngoscopy,impact on haemodynamic parameters and adverse events were recorded.Data statistically analysed using SPSS software with unpaired t-test and p<0.05 was considered significant.

RESULTS : No significant differences in demographic or airway variables were observed between the groups. Mean IDS score was 0.43(Standard deviation- 0.817) ,2.23(1.924),1.60(1.499) for Airtraq,Macintosh and MacCoy laryngoscope respectively.There was statistically significant increase in both heart rate and mean arterial pressure following intubation in Macintosh and MacCoy group as compared to Airtraq group.Cormach - Lehane grading have shown significant higher values in Macintosh group.

CONCLUSIONS : Airtraq significantly reduced mean IDS score with less alterations on hemodynamic varibles following intubation in contrast to Macintosh or MacCoy. These findings demonstrate the utility of Airtraq for tracheal intubation.