A prospective, randomised, clinical study to compare the use of McGrath ^® , Truview ^® and Macintosh laryngoscopes for endotracheal intubation by novice and experienced Anaesthesiologists

Abstract

Background and Aims:Video laryngoscopy has been recommended as an alternative during difficult conventional direct laryngoscopy using the Macintosh blade (MAC). However, successful visualisation of the larynx and tracheal intubation using some of the indirect laryngoscopes or video laryngoscopes (VL) requires hand-eye coordination. We conducted this study to determine whether non-channel VLs are easy to use for novices and whether there is any association between expertise with MAC and ease of tracheal intubation with VLs.Methods:Anaesthesiologists participating in the study were divided into three groups: Group novice to intubation (NTI), Group novice to videoscope (NVL)- experienced with MAC, novice to VLs and Group expert (EXP) experienced in all. Group NTI, NVL received prior mannequin training. VLs- Truview® and McGrath series 5 (MGR) were compared with MAC. One hundred and twenty six adult patients with normal airway were randomised to both, the intubating anaesthesiologist and laryngoscope. The time taken to intubate (TTI) and participants’ rating of the ease of use was recorded on a scale of 1–10 (10-most difficult).Results:In Group NTI, there was no difference in mean TTI with the three scopes (P = 0.938). In Group NVL, TTI was longer with the VLs than MAC (P < 0.001). In Group EXP, TTI with VL took 20 s more (P < 0.001). There was significant difference in participants’ rating of ease of use of laryngoscope in Group NVL (P = 0.001) but not in the NTI (P = 0.205), EXP (P = 0.529) groups. A high failure was seen with MGR in Group NTI and NVL.Conclusion:In Group NTI, TTI and the ease of use were similar for all scopes. Expertise with standard direct laryngoscopy does not translate to expertise with VLs. Separate training and experience with VLs is required.

Comparative Study of Truview Evo2 Laryngoscope With Macintosh Laryngoscope for Laryngoscopy and Intubation In Adults Receiving General Anaesthesia for Elective Surgeries

“…provides an anterior refraction of 42 thus provides better laryngeal 18 view.Agreeing with our study mean time for intubation was increased with8,12,14,17,[19][20][21][22][23][24] truview scope but few studies found equal time taken for 9-11,25…”

All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in adults

“…[2627] There is a definite learning curve for the successful use of a videolaryngoscope. [28] Anaesthesiologists should have access to a videolaryngoscope and must be trained to use it.…”

Comparison of Laryngeal Visualisation and Ease of Intubation Between Macintosh and Medan Video Laryngoscope

“…In a study by Bakshi et al 13 in which they compared the use of McGrath, Truview and Macintosh laryngoscopes for endotracheal intubation by novice and experienced anaesthesiologists and found that time to intubation was longer with the video laryngoscope than Macintosh in both NVL (novice to video laryngoscope) group and EXP (experienced in all) group. In many studies, video laryngoscope takes more time as compared to direct laryngoscope.…”