A randomised comparative study of “videoendoscope” with the Truview EVO2, C-MAC D blade videolaryngoscope and the Macintosh laryngoscope

Abstract

Background and Aims: Videolaryngoscopes are crucial components of a difficult airway cart. Issues of cost and availability, however, remain a problem. We compared the combination of an endoscope used in conjunction with the Macintosh laryngoscope with established videolaryngoscopes and the Macintosh laryngoscope using the intubation difficulty scale (IDS) score. Materials and Methods: A prospective randomised study including 120 adult patients, American Society of Anaesthesiologists (ASA) physical status I–III, with an anticipated difficult airway scheduled for elective surgery were randomly allocated to one of four groups: Truview EVO2 (group 1), C-MAC D Blade (group 2), videoendoscope (group 3), or Macintosh laryngoscope (group 4). The IDS score was the primary outcome. Secondary outcomes included the Cormack–Lehane grade, time to tracheal intubation, haemodynamic responses, and adverse events. Results: A significant proportion of patients in groups 2 and 3 had an IDS score of zero (73.3 and 70%, respectively). IDS scores were significantly lower in the C-MAC D blade and videoendoscope groups attributable to differences in parameters N4, N5 and N6 [C/L grades, lifting force and laryngeal pressure required] ( P < 0.001). The C-MAC D blade and the Macintosh laryngoscope required less time for intubation as compared to the Truview EVO2 and videoendoscope. No differences were noted in post-intubation haemodynamic parameters and other adverse events. Conclusion: The performance of videoendoscope was comparable to C-MAC D Blade and superior to Truview EVO2 and Macintosh laryngoscope with respect to the IDS score and may thereby provide an effective alternative to commercial videolaryngoscopes in low resource settings.

Performance of custom made videolaryngoscope for endotracheal intubation: A systematic review

“…Another 7 studies although had proposed a novel form of videolaryngoscope in the title, were not customised form for use [ 15 – 21 ] Other 5 studies out of 21 were editorials, case series, letters to editors with no human participation involved and with no intervention [ 4 , 22 – 25 ]. The remaining five studies were eligible and contained data with intervention performed in the patients [ 6 , 26 – 29 ]. Out of five, only three studies had a comparison group [ 26 – 28 ].…”

“…The remaining five studies were eligible and contained data with intervention performed in the patients [ 6 , 26 – 29 ]. Out of five, only three studies had a comparison group [ 26 – 28 ].…”

“…All the studies included were cross-sectional studies. Except for one study [ 26 ], other studies were graded as fair to poor quality based on NIH observational tool assessments ( Table 2 ). Almost all studies had the research objective stated and population defined.…”

“…Participation eligibility was also explained in all studies. Almost all studies except one study [ 26 ] had no justification for sample size, power description and effect estimates. Exposures measures were defined clearly in all studies except one [ 29 ].…”

Direct laryngoscopy versus video laryngoscopy for expected difficult tracheal intubation a prospective study

“…23 Even videoendoscope have comparable results with C MAC VL D blade and found superior to Truview EVO 2 and DL in anticipated difficult airway and provides a cheaper alternative to VL. 24 Regarding limitations in our study, we chose MMC alone to predict difficult intubations which might have lead to subjective variations. Though MMC III and IV holds good for the prediction of difficult intubation, it has high number of false positive ratings and a low predictive value.…”