Role of the Truview EVO2 laryngoscope in the airway management of elective surgical patients: A comparison with the Macintosh laryngoscope

Abstract

Background:The Truview EVO2(C) laryngoscope (TL) is a recently introduced optical device designed to provide an unmagnified anterior image of the glottic opening and allow indirect laryngoscopy.Aim:This study is designed to determine whether the TL is a better alternative to the Macintosh laryngoscope (ML) for routine endotracheal intubations in patients with usual airway characteristics.Methods:We compared the Truview EVO2(C) and MLs in 140 elective surgical patients requiring general anaesthesia and intubation in a prospective crossover fashion. The two blades were compared in terms of Cormack and Lehane grades, time required for intubation, anaesthetists’ assessment of ease of intubation, intubation difficulty score, attempts at intubation, success rate, soft tissue damage and arterial oxygen saturation during laryngoscopy. The Student t test and Chi-square test were used to determine the statistical significance of parametric data and categorical data, respectively.Results:The Truview EVO2(C) blade provided a better laryngoscopic view than the Macintosh blade as suggested by improved Cormack and Lehane grades (in 48 patients), but required a longer time for intubation than the Macintosh blade (34.1 vs. 22.4 s), i.e., an improved view at the cost of longer mean intubation time. In spite of lower intubation difficulty scores, Truview EVO2(C) was considered as difficult to use on subjective assessment by the anaesthesiologist when compared with Macintosh. There was no difference observed between the two groups in attempts at intubation, success rate, soft tissue damage and arterial oxygen saturation during laryngoscopy.Conclusion:We opine that although Truview provides a better laryngoscopic view than Macintosh in difficult cases, it does not have an extra benefit over Macintosh otherwise, further indicating the need for more experience with the use of a Truview laryngoscope.

Comparison of Laryngoscopic View Using Truview and Macintosh Laryngoscope for Intubation in Cervical in-Line Position Under General Anaesthesia

“…While in Macintosh group, no patients had IDS score 1 while 37, 8 and 51 patients had IDS score 2, 3 and 4 respectively. 9,13,16 Thus, the result in our study was comparable to the above study. Table 5 shows subjective assessment of intubation in both the groups on the basis of Intubation Difficulty Score.…”

“…While comparing the Cormack and Lehane grading in both the groups, it was found that grade 1 8,9,14 We did the study with cervical in-line stabilisation and found the same result. None of the patients had Grade-1 glottic visualisation in Macintosh group, the reason may be explained due to poor laryngoscopic view of glottis in cervical in-line position.…”

“…Truview PCD laryngoscope improves Cormack and Lehane grading by one or more grades without much difference in time required for negotiation of the endotracheal tube when compared with Macintosh Laryngoscope in patients with anticipated difficult airway. 8,9 The present study was planned to determine the usefulness of Truview laryngoscope for intubation in cervical in-line position in ASA grade I&II patients. For this purpose, we considered view of glottic exposure using the Cormack and Lehane grading as primary aim and time taken to intubation, ease of intubation and haemodynamic changes to laryngoscopy and intubation as secondary aim.…”

Comparison of Four Laryngoscopes for Orotracheal Intubation by Nurses During Resuscitation With and Without Chest Compressions: A Randomized Crossover Manikin Trial

“…Singh showed an 88% effectiveness of EVO2 intubation performed in 28.6 s [18]. Saxena et al, in a study among 140 surgical patients, observed that anaesthesiologists needed an average of 34.1 s to perform intubation using EVO2, which was a statistically significantly longer time than they required for direct laryngoscopy intubation (22.4 s) [19]. Similarly, a longer intubation time using EVO2 as compared with MAC (33.06 ± 5.6 vs. 23.11 ± 5.7 s, respectively) was noted by Timanaykar et al [20].…”

To Compare the Haemodynamic Response to Laryngoscopy and Tracheal Intubation Using the Standard Macintosh Laryngoscope Versus Videolaryngoscope Among Healthy Adult Individuals Receiving General Anaesthesia for Elective Surgery

“…In the present study all the intubation were successfully performed in both the groups, which was in accordance with observation of various other studies. (21)(22)(23)(24) However, some studies (25,26) show higher success rate with videolaryngoscope as compared to Macintosh laryngoscope. The lower success rate in Macintosh group might be due to inclusion of Mallampati grade 1 and 2 patients.…”