To compare the performance of the McGrath Mac ® and the Airtraq ® with the Macintosh laryngoscope for tracheal intubation. Design: A manikin study with different simulated difficult airway scenarios. Methods: Thirty intensive care unit (ICU) doctors (10 specialists and 20 non-specialists) performed intubation by using the 3 airway devices in the manikin with (i) normal airway, (ii) cervical rigidity, and (iii) tongue oedema. The intubation time, success rate, oesophageal intubation and number of episodes of dental injury were measured and compared. Results: The mean intubation time was significantly less by using the Airtraq ® comparing to the McGrath Mac ® in the manikin with normal airway (12.77 sec vs. 24.23 sec; p<0.001). Similarly, the mean intubation time was less by using Airtraq ® when comparing to the McGrath Mac ® in the manikin with cervical rigidity (12.73 sec vs. 17.5 sec; p=0.013). In the scenario of simulated tongue oedema, the mean intubation time of Airtraq ® was shorter than Macintosh laryngoscope (24.83 sec vs. 34.20 sec; p=0.011) while there was no difference between Airtraq ® and the McGrath Mac ®. Less dental injury was noted when using the Airtraq ® compared to the Macintosh laryngoscope in simulated cervical rigidity (p=0.005) and tongue oedema (p<0.001). Less dental injury was also noted when using the McGrath Mac ® compared to the Macintosh laryngoscope in simulated tongue oedema (p<0.001). Conclusion: Even with prior limited experience in using the McGrath Mac ® , the performance of tracheal intubation by using this new device is comparable with the Airtraq ®. The McGrath Mac ® can be a good alternative for tracheal intubation in difficult airway situations.
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