A randomised controlled trial comparing the McGrath^® videolaryngoscope with the straight blade laryngoscope when used in adult patients with potential difficult airways*

Abstract

SummaryStudies show that both straight blade laryngoscopy and videolaryngoscopy can improve the view of the larynx when compared with the Macintosh blade laryngoscopy. However, no study has compared these two devices. A total of 80 patients with Mallampati grade ≥ 3 were randomly assigned to either have orotracheal intubation with the McGrath® videolaryngoscope or the Henderson straight blade. The primary outcome was laryngoscopic view. Time to intubation, number of attempts, ease of intubation and complications were also recorded. Thirty‐nine out of 40 patients had grade‐1 views in the McGrath group, compared with 29 out of 40 cases in the Henderson group (p = 0.003). There were no statistically significant differences in the secondary outcomes. Two patients suffered from minor oropharyngeal injuries in the Henderson group. Apart from offering significantly more grade‐1 laryngoscopic views, the McGrath videolaryngoscope did not improve other clinical outcomes compared with the straight blade, when used in patients with poor Mallampati scores.

Cardiac arrest is a predictor of difficult tracheal intubation independent of operator experience in hospitalized patients

“…This finding in isolation would support the preferential use of advanced airway technologies, such as VL devices to improve first attempt intubation success, and presumably, decrease the chances of intubation-related complications. In fact, a number of investigators have documented improvements in a variety of intubation related endpoints with the use of VL compared to DL in both human [23-31] and mannequin studies [32-35]. However, our results do not support this assertion.…”

Comparison of McGRATH MAC and Macintosh laryngoscopes for double-lumen endotracheal tube intubation by anesthesia residents: a prospective randomized clinical trial

“…The McGRATH MAC (McG; Aircraft Medical Ltd, Edinburgh, UK) laryngoscope includes a high-resolution video camera, allowing for direct and indirect views of the glottis, and is reportedly useful for difficult airways [6]. Compared with the direct Macintosh laryngoscope (McL), the McG shortens intubation time and improves the success rate of the first attempt at intubation in normal and difficult airways [7,8]. However, the utility of the McG for DLT intubation has not been evaluated.…”

A randomized, crossover model-based study of five different laryngoscopes in normal airway scenario

“…On the other hand, another study compared McGrath with straight blades but could not display any superiority in terms of clinical results. [14] However, differently from our study, Mallampati grade of ≥3 patients having potential for difficult intubation were included in the study mentioned above. Although experience with video game play have been reported to have some negative effects, [15] we discovered a positive correlation in psychomotor skills of those participants who played video games on a regular basis.…”