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. 2015 Jul;59(7):421-7.
doi: 10.4103/0019-5049.160946.

A prospective, randomised, clinical study to compare the use of McGrath(®), Truview(®) and Macintosh laryngoscopes for endotracheal intubation by novice and experienced Anaesthesiologists

Sumitra G Bakshi  1 , Vinayak S Vanjari  1 , Jigeeshu V Divatia  1
Affiliations

A prospective, randomised, clinical study to compare the use of McGrath(®), Truview(®) and Macintosh laryngoscopes for endotracheal intubation by novice and experienced Anaesthesiologists

Sumitra G Bakshi et al. Indian J Anaesth. 2015 Jul.

Abstract

Background and aims: Video laryngoscopy has been recommended as an alternative during difficult conventional direct laryngoscopy using the Macintosh blade (MAC). However, successful visualisation of the larynx and tracheal intubation using some of the indirect laryngoscopes or video laryngoscopes (VL) requires hand-eye coordination. We conducted this study to determine whether non-channel VLs are easy to use for novices and whether there is any association between expertise with MAC and ease of tracheal intubation with VLs.

Methods: Anaesthesiologists participating in the study were divided into three groups: Group novice to intubation (NTI), Group novice to videoscope (NVL)- experienced with MAC, novice to VLs and Group expert (EXP) experienced in all. Group NTI, NVL received prior mannequin training. VLs- Truview(®) and McGrath series 5 (MGR) were compared with MAC. One hundred and twenty six adult patients with normal airway were randomised to both, the intubating anaesthesiologist and laryngoscope. The time taken to intubate (TTI) and participants' rating of the ease of use was recorded on a scale of 1-10 (10-most difficult).

Results: In Group NTI, there was no difference in mean TTI with the three scopes (P = 0.938). In Group NVL, TTI was longer with the VLs than MAC (P < 0.001). In Group EXP, TTI with VL took 20 s more (P < 0.001). There was significant difference in participants' rating of ease of use of laryngoscope in Group NVL (P = 0.001) but not in the NTI (P = 0.205), EXP (P = 0.529) groups. A high failure was seen with MGR in Group NTI and NVL.

Conclusion: In Group NTI, TTI and the ease of use were similar for all scopes. Expertise with standard direct laryngoscopy does not translate to expertise with VLs. Separate training and experience with VLs is required.

Keywords: Airway training; experience and intubation using video scopes; video laryngoscopes.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Time to Intubate (TTI). NTI -Novice to intubation, NVL -Novice to videoscope, EXP -Expert group. TTI was compared for each scope within and between groups using Kruskal-Wallis test, P < 0.05 was significant. The within-group analysis was further done using Mann-Whitney test, P < 0.016 was significant. For P values refer text
Figure 2
Figure 2
Ease of use of scope (Numerical Rating Scale [NRS] scores). MAC -Macintosh, MGR -McGrath, TVW -Truview scope. NTI -Novice to intubation group, NVL -Novice to videoscope group, EXP -Expert group. NRS was compared for each scope within and between groups using Kruskal-Wallis test, P < 0.05 was significant. The within-group analysis was further done using Mann-Whitney test, P < 0.016 was significant. For P values refer text
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