A comparison of the ease of tracheal intubation using a McGrath MAC^® laryngoscope and a standard Macintosh laryngoscope

Abstract

SummaryWe compared the McGrath MAC â videolaryngoscope when used as both a direct and an indirect laryngoscope with a standard Macintosh laryngoscope in patients without predictors of a difficult tracheal intubation. We found higher median Intubation Difficulty , respectively (p = 0.01). This difficulty is in part explained by the poorer laryngeal views recorded using the Cormack and Lehane classification system (p < 0.001) and reflected in the higher than normal operator force required (25%, 4%, 8% for each method, respectively, p < 0.001) and the increased use of rigid intubation aids (21%, 6%, 2%, respectively, p < 0.001). There was no difference between the groups in time taken to intubate or incidence of complications. There was no statistical difference in the performances as measured between the McGrath MAC used as an indirect videolaryngoscope and the Macintosh laryngoscope. We cannot recommend that the McGrath videolaryngoscope be used as a direct laryngscopic device in place of the Macintosh.

Videolaryngoscopy in real patients – a welcome change

“…By following the Difficult Airway Society's ADEPT guidance [9] and performing this useful equipment study, Wallace et al have contributed important scientific data to an area bedevilled by enthusiastic anecdotes of usefulness. [1], and others have confirmed this communication clinically [2][3][4].…”

A comparison between McGrath MAC videolaryngoscopy and Macintosh laryngoscopy in children

“…This longer intubation time can be mediated by insufficient skill with using the McGrath VL. For instance, in a study by Wallace, time to intubation (median [IQR]) in adults was considerably high (37 [30–45] s), and it is reasonable to presume that none of the five laryngoscopists in that study were sufficiently proficient in the use of McGrath VL.…”

Strategies for the prevention of airway complications – a narrative review

“…In the MACMAN study, although the study was generally well designed, the protocol had a few anomalies which included the use of predominantly inexperienced tracheal intubators, and uncertainty over the extent of training with the videolaryngoscope. The McGrath MAC videolaryngoscope has also been studied in routine anaesthesia, without showing any apparent benefit over direct laryngoscopy . It would be of value to repeat this study using a device of proven benefit in the anaesthetic setting and used by operators trained and expert in the device.…”