Comparison between macintosh, miller and mccoy laryngoscope blade size 2 in paediatric patients – A randomised controlled trial

Yadav, Prakarsh; Kundu, Sudeshna Bhar; Bhattacharjee, Dhurjoti Prosad

doi:10.4103/ija.ija_307_18

Cited by 6 publications

(7 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…in 74 children also found similar results with the Miller blade (0.6 ± 0.7) compared with the conventional Miller blade in our study. [ 25 ] We also inferred in our study that the number of patients requiring external laryngeal manipulation was more in the Miller DL group compared to C-MAC VL. The possible explanation for this could be attributed to the fact that the inline view of the glottic aperture is not required in the C-MAC VL, as a camera at the tip of the blade gives a wider visual angle.…”

Section: Discussionsupporting

confidence: 54%

Comparison of C-MAC Miller blade video laryngoscope with conventional Miller blade in infants undergoing elective surgery- A prospective randomised trial

et al. 2023

View full text Add to dashboard Cite

Background and Aims: Endotracheal intubation (ET) in infants is considered a challenging task over the decades. Infants have short safe apnoea time, and this difficulty has been vanquished to some extent by using the videolaryngoscopes (VLs), but there exists a dearth of research particularly in this vulnerable subset. Therefore, this trial was conducted to evaluate intubation times obtained with C-MAC VL and conventional Miller laryngoscopes in infants. Methods: A total of 80 infants aged between 1 month and 1 year with American Society of Anesthesiologists physical status I-II requiring ET were randomised in two groups; the C-MAC VL or Miller laryngoscope ML. Anaesthesia was induced with sevoflurane 1–8% and atracurium 0.5 mg/kg IV. The primary outcome was evaluated as the total time taken to intubate. Secondary outcomes were time to achieve best glottic view (TBGV), tube insertion time (TIT), percentage of glottic opening (POGO) score, number of attempts and intubation difficulty score (IDS). Results: The median (interquartile range) of time taken for ET was less in VL; 22.5 (20.75–26) compared to ML; 26 (21.75–31). TBGV was achieved early in VL group than the ML group (6.03 ± 1.33s/7.88 ± 2.44) respectively (P-value < 0.001). POGO was better in VL (99.12 ± 4.795s) compared to ML (85.50 ± 31.13s). IDS was less in the VL group (0.07 ± 0.27) than in ML (0.70 ± 1.14). Other parameters, such as the number of attempts, bougie usage, adverse effects and TIT, were comparable across the two groups. Conclusion: When compared to the ML group, the C-MAC VL group exhibited a decreased intubation time, early TBGV, better POGO score, reduced IDS and subjective intubation difficulty. As a result, we consider VL to be a more efficacious device for intubating the trachea in infants.

show abstract

Section: Discussionsupporting

confidence: 54%

Comparison of C-MAC Miller blade video laryngoscope with conventional Miller blade in infants undergoing elective surgery- A prospective randomised trial

et al. 2023

View full text Add to dashboard Cite

show abstract

“…The median (IQR) for time to glottic view time was 6 s [5-7] versus 8.0 s [6][7][8][9][10]; p = .006 (Figure 2A), Time to intubation was 9 s [7-14] versus. 12 s [6-10]; p = .011 (Figure 2B) and the total duration of intubation was 20 s [16-22] vs. 18 s [15][16][17][18][19][20][21][22]; p = .374 (Figure 2C) for…”

Section: Most Patients Had CL Grade I With C-mac D-blade Unlike Mccoymentioning

confidence: 99%

“…14 It works well in difficult laryngoscopy situations, and there have been many clinical reports of success when the glottis was not visualized with the Macintosh laryngoscope. 15,16 Both the devices, McCoy and C-MAC have been independently compared with the Macintosh laryngoscope. A few studies are available that compare C-MAC and McCoy laryngoscopes in adult patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A prospective randomized comparative trial of pediatric C‐MAC D‐blade video laryngoscope with McCoy direct laryngoscope for intubation in children posted for elective surgical procedures under general anesthesia

Kamal,

Agarwal,

Agarwal

et al. 2024

Pediatric Anesthesia

View full text Add to dashboard Cite

BackgroundPediatric airway management requires careful clinical evaluation and experienced execution due to anatomical, physiological, and developmental considerations. Video laryngoscopy in pediatric airways is a developing area of research, with recent data suggesting that video laryngoscopes are better than standard Macintosh blades. Specifically, there is a paucity of literature on the advantages of the C‐MAC D‐blade compared to the McCoy direct laryngoscope.MethodsAfter Ethics Committee approval, 70 American Society of Anesthesiologists physical status 1 and 2 children aged 4–12 years scheduled for elective surgery under general anesthesia were recruited. Patients were randomly allocated to intubation using a C‐MAC video laryngoscope size 2 D‐blade (Group 1) and a McCoy laryngoscope size 2 blade (Group 2). The Intubation Difficulty Scale (IDS) for ease of intubation was the primary outcome, while Cormack–Lehane grades, duration of laryngoscopy and intubation, hemodynamic responses, and incidence of any airway complications were secondary outcomes.ResultsBoth groups were comparable in terms of patient characteristics. The median (IQR) Intubation Difficulty Scale (IDS) score was better but was statistically nonsignificant with C‐MAC (0 [0–0] vs. 0 [0–2], p = .055). The glottic views were superior (CL grade I in 32/35 vs. 23/35, p = .002), and the time to best glottic view (6 s [5–7] vs. 8.0 s [6–10], p = .006) was lesser in the C‐MAC D‐blade group while the total duration of intubation was comparable (20 s [16–22] vs. 18 s [15–22], p = .374). All the patients could be successfully intubated on the first attempt. None of the patients had any complications.ConclusionThe C‐MAC video laryngoscope size 2 D‐blade provided faster and better glottic visualization but similar intubation difficulty compared to McCoy size 2 laryngoscope in children. The shorter time to achieve glottic view demonstrated with the C‐MAC failed to translate into a shorter total duration of intubation when compared to the McCoy laryngoscope attributable to a pronounced curvature of the D‐blade.

show abstract

“…13 Cormack-Lehane grade and percentage of glottic opening (POGO) score in 75 children aged 2-6 years, scheduled for elective surgery under general anesthesia, were studied by Yadav et al in which they were randomly allocated to groups A, B, and C to be intubated with Macintosh, Miller, and McCoy blades, respectively, where they found a significant difference with the Miller blade as compared with the Macintosh and Miller blade. 14 The laryngoscopic view and intubating conditions using Macintosh and Miller blades in small children (1-24 months) in 120 children were studied by Varghese and Kundu. The laryngoscopic view was similar with both blades in 43% of children and differed in the remaining 57% (68) children.…”

Section: Randomized Control Trial Study On Miller Laryngoscope To Com...mentioning

confidence: 99%

Utility of Adult Miller Blade

Mishra¹,

Pandey²,

Charles³

2023

Annals of SBV

View full text Add to dashboard Cite

Skillful airway management is an essential prerequisite for orotracheal intubation both in emergencies and elective surgeries requiring general anesthesia. Both Miller and Macintosh blades are very commonly and widely used for intubations in all patient age groups, though the Macintosh blade is more commonly recommended in the adult population and the Miller blade in the pediatric population as evidenced in the existing literature. A better view of the glottis is obtained with the adult straight Miller blade as it has a narrow tip and hence gives a wider working space to negotiate an endotracheal tube that leads to an improved line of sight to the glottis. A review of the literature was conducted to summarize existing evidence of the adult Miller on ease of orotracheal intubation, glottic view, time taken for intubation, and hemodynamic changes, and there is very little literature comparing the Miller blade and Macintosh blade use in the adult population.

show abstract

Comparison between macintosh, miller and mccoy laryngoscope blade size 2 in paediatric patients – A randomised controlled trial

Cited by 6 publications

References 12 publications

Comparison of C-MAC Miller blade video laryngoscope with conventional Miller blade in infants undergoing elective surgery- A prospective randomised trial

Comparison of C-MAC Miller blade video laryngoscope with conventional Miller blade in infants undergoing elective surgery- A prospective randomised trial

A prospective randomized comparative trial of pediatric C‐MAC D‐blade video laryngoscope with McCoy direct laryngoscope for intubation in children posted for elective surgical procedures under general anesthesia

Utility of Adult Miller Blade

Contact Info

Product

Resources

About