Comparison of cricoid pressure effect between McGRATH® MAC and Pentax-AWS Airwayscope®: A prospective randomized trials

Komasawa, Nobuyasu; Kido, Haruki; Mihara, Ryosuke; Minami, Toshiaki

doi:10.1016/j.ajem.2016.12.016

Cited by 10 publications

(19 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, direct glottic views can be obtained at any time during intubation, even when the glottis is not visible because of secretions or fog. 3,6 The Pentax Airway Scope VL (Pentax Co., Tokyo, Japan) (PVL) is a channelled indirect VL. It has a disposable blade with two channels, a monitor, and an image tube containing a camera.…”

mentioning

confidence: 99%

Randomized comparison of McGrath MAC videolaryngoscope, Pentax Airway Scope, and Macintosh direct laryngoscope for nasotracheal intubation in patients with manual in-line stabilization

Roh

Kwak

Lee

et al. 2019

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Background The objective of this study was to determine the clinical usefulness of videolaryngoscopes (VLs) by comparing the time to intubation (TTI) and the ease of intubation of McGrath MAC VL (MVL), Pentax Airway Scope VL (PVL), and Macintosh direct laryngoscope (DL) during nasotracheal intubation using manual in-line stabilization to simulate difficult airways. Methods One hundred and twenty patients were randomly assigned to the MVL group (n = 40), the PVL group (n = 40), and the DL group (n = 40). Nasotracheal intubation was performed using MVL, PVL, or DL, according to group assignments. The primary outcome was TTI and secondary outcomes were glottic view, ease of intubation, and bleeding. ResultsThe TTI was significantly shorter in the MVL group than in the DL group (45 sec vs 57 sec; difference in means: -12; 95% confidence interval [CI], -21 to -3; P = 0.01). The percentage of glottic opening and Cormack Lehane grade were significantly superior in the MVL and the PVL groups compared with the DL group (both P \ 0.001). The intubation difficulty scale and numeric rating scale regarding ease of intubation were also significantly lower in the MVL and PVL groups than in the DL group (all P\0.007). The incidence of bleeding was significantly lower in the MVL group than in the DL group (3 vs 15, relative risk 0.2; 95% CI, 0.06 to 0.64; P = 0.001). Conclusion This study showed that both MVL and PVL provided better visualization of the glottis and easier intubation, with less additional manipulation than DL during nasotracheal intubation in simulated difficult airways. Additionally, use of the MVL significantly shortened the TTI compared with the DL. Trial registration www.clinicaltrials.gov (NCT02647606); registered 6 January, 2016. RésuméContexte L'objectif de cette étude était de déterminer l'utilité clinique des vidéolaryngoscopes (VL) en comparant le temps jusqu'à intubation (TTI) et la facilité d'intubation du VL McGrath MAC (MVL), du VL Pentax Airway Scope (PVL), et du laryngoscope avec lame Macintosh (DL) pour une intubation nasotrachéale avec

show abstract

mentioning

confidence: 99%

Randomized comparison of McGrath MAC videolaryngoscope, Pentax Airway Scope, and Macintosh direct laryngoscope for nasotracheal intubation in patients with manual in-line stabilization

Roh

Kwak

Lee

et al. 2019

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…Other manikin studies also found that the TTI using the McGrath VL was significantly longer compared with other VLs, including the Pentax AWS; that study used a chest compression, immobilized cervical spine, and car victim model to simulate various difficult intubation situations. [ 18 , 21 , 22 ] In contrast, Komasawa et al [ 23 ] found that the intubating time was longer with the Pentax AWS compared with the McGrath VL in patients who received cricoid pressure during intubation; the authors explained that this was due to the McGrath VL providing both an indirect and direct glottic view, whereas the Pentax AWS only provided an indirect view by video camera.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Pentax AirwayScope and McGrath MAC videolaryngoscope for endotracheal intubation in patients with a normal airway

et al. 2017

View full text Add to dashboard Cite

Various videolaryngoscopes (VLs) have been developed to provide a better laryngeal view and facilitate difficult intubations. The goal of this study was to compare 2 VLs, the Pentax AWS and the McGrath VL, with respect to intubation time and ease of intubation.One hundred forty patients aged 19 to 65 years (American Society of Anesthesiologists classification I or II), who required tracheal intubation for elective surgery, were randomly assigned to 1 of the 2 groups: the Pentax AWS (n = 70) or the McGrath VL (n = 70). The primary outcome was time to intubation (TTI) measured by a blind observer. The intubation difficulty scale (IDS), percentage of glottic opening (POGO) scale, glottic grade, use of optimal external laryngeal manipulation (OELM), and ease of intubation were also recorded.The Pentax AWS provided a better laryngeal view than the McGrath VL with respect to the Cormack-Lehane (CL) glottic grade (1/2a/2b) (63/7/0 vs 43/24/3, P < .001) and the POGO scale (median [interquartile range, IQR]) (100 [100–100] vs 100 [80–100], P < .001). The IDS was significantly lower in the Pentax AWS group compared with the McGrath VL group (median [IQR]) (0 [0–0] vs 0 [0–1], P < .001). However, the TTI was similar in both the Pentax AWS and McGrath VL groups (median [IQR]) (30 [27–34] vs 32 [27–35] seconds, P = .440). OELM and ease of intubation were also similar between the 2 groups.The Pentax AWS offered a superior laryngeal view compared with the McGrath VL. There was no significant difference in either the intubation time or ease of intubation using these 2 devices in patients with normal airways.

show abstract

“…Another 11 articles were excluded because of a crossover design (n = 2), tracheal intubation without the use of laryngoscopic approach (n = 6), non-RCT (n = 1), mere description of a study protocol (n = 1), and lack of data on the SFAIR (n = 1). Finally, a total of five full-text randomized trials (published between 2005 and 2018) 11,[18][19][20][21] were included in the current metaanalysis (Fig. 1).…”

Section: Literature Searchmentioning

confidence: 99%

“…All studies were conducted in the operating room. Four studies 11,[18][19][20] included patients without risks for aspiration and difficult airway scheduled for elective surgery without RSI during anesthetic induction. A trial that investigated 3,471 patients with risk for aspiration undergoing elective or emergent surgery with RSI reported intermediate risk for difficult intubation in up to approximately one third of patients.…”

Section: Characteristics Of Trials and Patientsmentioning

confidence: 99%

“…21 Two studies 11,21 specifically applied the bimanual technique (i.e., the assistant's hand was placed behind the neck) during airway management and two studies 18,19 adopted the onehand technique, while one study did not specify the technique. 20 Intubations were performed via the oral route in operating theaters with the use of neuromuscular blocking agents. In terms of intubators, while tracheal intubations were exclusively performed by anesthesiologists in four studies, 11,[18][19][20] nurse anesthetists were responsible for 66% of the intubations, with the rest Fig.…”

Section: Characteristics Of Trials and Patientsmentioning

confidence: 99%

See 1 more Smart Citation

The effect of cricoid pressure on tracheal intubation in adult patients: a systematic review and meta-analysis

Hung

Poon

et al. 2020

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose This meta-analysis aimed to assess the impact of cricoid pressure (CP) application on intubation outcomes. Source Electronic databases (i.e., MEDLINE, PubMed, Embase, and Cochrane review) were searched from inception to 2 June 2020 for randomized-controlled trials that assessed the intubation outcomes in adult patients using laryngoscopic approaches with and without the application of CP (i.e., CP vs non-CP group). The primary outcome was the successful first-attempt intubation rate (SFAIR), and the secondary outcomes were intubation time, incidences of poor laryngoscopic views (i.e., Cormack and Lehane grade 3-4), airway complications, and pulmonary aspiration. Principal findings A total of five trials (published from 2005 to 2018) were included, and all tracheal intubations were performed by anesthesiologists or nurse anesthetists with a video (n = 3) or Macintosh laryngoscope (n = 2) in the operating room. We found no significant difference in Kuo-Chuan Hung and Chao-Ting Hung contributed equally to this work.

show abstract

Comparison of cricoid pressure effect between McGRATH® MAC and Pentax-AWS Airwayscope®: A prospective randomized trials

Cited by 10 publications

References 4 publications

Randomized comparison of McGrath MAC videolaryngoscope, Pentax Airway Scope, and Macintosh direct laryngoscope for nasotracheal intubation in patients with manual in-line stabilization

Randomized comparison of McGrath MAC videolaryngoscope, Pentax Airway Scope, and Macintosh direct laryngoscope for nasotracheal intubation in patients with manual in-line stabilization

Comparison of the Pentax AirwayScope and McGrath MAC videolaryngoscope for endotracheal intubation in patients with a normal airway

The effect of cricoid pressure on tracheal intubation in adult patients: a systematic review and meta-analysis

Contact Info

Product

Resources

About