Comparison of TruView EVO2 with Miller laryngoscope in paediatric patients

Abstract

Background: Except for neonates and specific malformations in children, management of the paediatric airway is not a major problem for the anaesthetist. Miller laryngoscope was traditionally used for paediatric intubation. The TruView EVO2 system is a recently introduced device with a unique blade that provides a wide and magnified laryngeal view.

Objective: To assess the value of the TruView EVO2 laryngoscope with that of Miller laryngoscope in paediatric patients.

Design: Prospective analysis.

Measurements and results: Fifty 2-8-year paediatric patients presenting for surgery requiring tracheal intubation were randomly assigned to undergo intubation using a Miller (Group M, n = 25) and TruView EVO2 laryngoscope (Group T, n = 25). Preoperative airway evaluation was performed by using the Mallampati scores. The Intubation Difficulty Scale (IDS), the duration of the tracheal intubation procedure, the rate of successful placement of the endotracheal tube in the trachea, the view of the glottis according to the Cormack and Lehane grading criteria, number of intubation attempts, mean arterial pressure (MAP) and heart rate (HR) before and after intubation, lowest peripheric oxygen saturation during intubation attempts and all complications (minor laseration, dental or other airway trauma) were all recorded.

Results: Preoperative Mallampati scores and the IDS scores were similar between the Miller and TruView EVO2 laryngoscope. The average time for laryngoscopy was 6.36 ± 0.99 s in group M and 13.8 ± 7.99 s in group T (P < 0.001). The TruView EVO2 laryngoscope improved the Cormack and Lehane glottic view compared with the Miller laryngoscope. The HR change (difference before and after) in group M was significantly lower than that in group T (P < 0.001). However, the MAP change was similar between groups. The lowest peripheric oxygen saturation during intubation attempts was different between groups, 99.4 ± 0.57% in group M and 97.6 ± 2.41% in group T (P < 0.001).

Conclusion: The results suggest that when compared with the Miller laryngoscope, the TruView EVO2 laryngoscope appears to improve the view of the larynx but requires a longer time for tracheal intubation. The IDS scores were similar; thus, the TruView EVO2 laryngoscope can be a good alternative to traditionally used Miller laryngoscope.