The McGrath Series 5 video laryngoscope versus the Macintosh laryngoscope: a randomized trial in obstetric patients

Aydın, Ferid; Çakmakçı, Songül

doi:10.3906/sag-1306-71

Cited by 29 publications

(32 citation statements)

References 44 publications

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“…The remaining 61 studies took place in the hospital operating theatre setting with elective surgical participants. Two studies specified inclusion of only obese participants, 21 23 one study included only obstetric participants, 25 one study only participants with untreated hypertension, 35 and one study only participants from the burns unit. 82 We included three studies that used a double-lumen tracheal tube for intubation.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation: a Cochrane Systematic Review

Lewis

Butler

Parker

et al. 2017

British Journal of Anaesthesia

278

216

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Difficulties with tracheal intubation commonly arise and impact patient safety. This systematic review evaluates whether videolaryngoscopes reduce intubation failure and complications compared with direct laryngoscopy in adults. We searched CENTRAL, MEDLINE, Embase and clinicaltrials.gov up to February 2015, and conducted forward and backward citation tracking. We included randomized controlled trials that compared adult patients undergoing laryngoscopy with videolaryngoscopy or Macintosh laryngoscopy. We did not primarily intend to compare individual videolaryngoscopes. Sixty-four studies (7044 participants) were included. Moderate quality evidence showed that videolaryngoscopy reduced failed intubations (Odds Ratio (OR) 0.35, 95% Confidence Interval (CI) 0.19-0.65) including in participants with anticipated difficult airways (OR 0.28, 95% CI 0.15-0.55). There was no evidence of reduction in hypoxia or mortality, but few studies reported these outcomes. Videolaryngoscopes reduced laryngeal/airway trauma (OR 0.68, 95% CI 0.48-0.96) and hoarseness (OR 0.57, 95% CI 0.36-0.88). Videolaryngoscopy increased easy laryngeal views (OR 6.77, 95% CI 4.17-10.98) and reduced difficult views (OR 0.18, 95% CI 0.13-0.27) and intubation difficulty, typically using an 'intubation difficulty score' (OR 7.13, 95% CI 3.12-16.31). Failed intubations were reduced with experienced operators (OR 0.32, 95% CI 0.13-0.75) but not with inexperienced users. We identified no difference in number of first attempts and incidence of sore throat. Heterogeneity around time for intubation data prevented meta-analysis. We found evidence of differential performance between different videolaryngoscope designs. Lack of data prevented analysis of impact of obesity or clinical location on failed intubation rates. Videolaryngoscopes may reduce the number of failed intubations, particularly among patients presenting with a difficult airway. They improve the glottic view and may reduce laryngeal/airway trauma. Currently, no evidence indicates that use of a videolaryngoscope reduces the number of intubation attempts or the incidence of hypoxia or respiratory complications, and no evidence indicates that use of a videolaryngoscope affects time required for intubation.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation: a Cochrane Systematic Review

Lewis

Butler

Parker

et al. 2017

British Journal of Anaesthesia

278

216

View full text Add to dashboard Cite

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“…They found no difference regarding intubation times between the McGrath VL and the Macintosh DL. Arıcı et al [11] also found an increment in intubation times with the McGrath VL in their study with obese pregnant women. In this study, although the glottic image was better and the anaesthesiologist had experience with the McGrath VL, we found a longer duration of the intubation period in Group V. Another aspect, when compared with the Macintosh, was that a gum elastic bougie is needed more frequently for intubation with the McGrath VL [18].…”

Section: Discussionmentioning

confidence: 71%

Comparison of direct laryngoscope and McGrath videolaryngoscope in terms of glottic view and hemodynamic in bariatric surgery

Çakir

Özyurt

2020

Turk J Med Sci

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Background/aim: In the recent years, videolaryngoscopes (VL) have emerged as alternative devices to direct laryngoscopes (DL) in difficult intubation situations. Therefore, we aimed to compare the Macintosh DL and McGrath VL in terms of the glottic image quality, intubation success, intubation time, hemodynamic response after intubation, and complications in bariatric surgery patients. Material and methods:After obtaining approval by the ethics committee and receiving informed consent, we recorded the demographic and physical data of patients undergoing bariatric surgery. Patients were divided into 2 groups: Group M was intubated with the Macintosh DL, and Group V was intubated with the McGrath VL. After intubation, we noted the Cormack-Lehane score, the duration of intubation, the number of intubation interventions, and the hemodynamic data of patients. Results:A total of 62 patients (ASA II, body mass index of >35 kg/m 2 ) were included in the study. All patients except 1 patient were intubated on the first attempt. Although there was a decrease in heart rate and blood pressure with induction, similar hemodynamic data were obtained between groups during the operation. In group V, we obtained a better glottic image (P = 0.011), but intubation success was similar between the study groups. We also measured the intubation time in group M as 45.9 ± 19.1 s and group V as 57.1 ± 15.8 s (P = 0.015).Discussion: Although we measured longer intubation times with the McGrath VL compared with the Macintosh DL, we obtained a better glottic image without causing hemodynamic changes. However, these findings did not make any difference in terms of intubation success.

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“…Currently, they are stocked in 90% of obstetric units in the UK [12]. In obstetric practice, videolaryngoscopes have been used at elective caesarean section, in morbidly obese patients and during failed intubation [116][117][118][119][120][121][122][123][124][125]. However, currently there are no comparative studies of the best videolaryngoscope for the obstetric population [126].…”

Section: First Intubation Attemptmentioning

confidence: 99%

Obstetric Anaesthetists’ Association and Difficult Airway Society Guidelines for the Management of Difficult and Failed Tracheal Intubation in Obstetrics

Mushambi¹,

Kinsella²,

Popat³

et al. 2016

Obstetric Anesthesia Digest

114

221

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SummaryThe Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably secondgeneration) supraglottic airway device if appropriate. Algorithm 3 covers the management of the 'can't intubate, can't oxygenate' situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how to awaken or proceed with surgery. The background paper covers recommendations on drugs, new equipment, teaching and training.

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The McGrath Series 5 video laryngoscope versus the Macintosh laryngoscope: a randomized trial in obstetric patients

Cited by 29 publications

References 44 publications

Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation: a Cochrane Systematic Review

Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation: a Cochrane Systematic Review

Comparison of direct laryngoscope and McGrath videolaryngoscope in terms of glottic view and hemodynamic in bariatric surgery

Obstetric Anaesthetists’ Association and Difficult Airway Society Guidelines for the Management of Difficult and Failed Tracheal Intubation in Obstetrics

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