An evaluation of the TruView EVO2 laryngoscope

Abstract

SummaryThe TruView EVO2 laryngoscope was compared with the traditional Macintosh laryngoscope in 200 patients who required tracheal intubation for elective surgery. Mallampati score determined prior to laryngoscopy was significantly related to the view of the glottis during laryngoscopy for both laryngoscopes. The view of the larynx was better with the TruView EVO2 laryngoscope than with the Macintosh laryngoscope in patients with a Cormack and Lehane grade greater than 1 (p < 0.01). The mean time to intubate was significantly shorter with the Macintosh laryngoscope (34 s) than with the TruView laryngoscope (51 s) (p < 0.01). Many cases of difficult intubation are unanticipated and are frequently not recognised during pre-operative assessment [1]. Many different designs of laryngoscopes have been developed in an effort to reduce the incidence of this problem [2][3][4].The TruView EVO2 laryngoscope (Truphatek International Ltd, Netanya, Israel) is a recently introduced device with a unique blade that provides an optical view 'around the corner'. The blade is a modified laryngoscope blade incorporating an unmagnified optic side port with anterior fraction of 35% in the line of sight allowing indirect tracheal intubation [5].The aim of this study was to compare the TruView EVO2 laryngoscope with the direct Macintosh laryngoscope. We wished to determine whether the TruView EVO2 laryngoscope provided an improved view at laryngoscopy compared to that provided by the Macintosh laryngoscope and to also to assess the time taken for intubation with these two devices. MethodsApproval for the study was obtained from the hospital research ethics committee and written informed consent was obtained from each patient participating. Patients were considered appropriate for recruitment if they were undergoing elective surgery for which tracheal intubation was planned. Exclusion criteria included the presence of raised intracranial pressure, cervical spine injury, risk factors for pulmonary aspiration of gastric contents and the presence of any pathology of the head and neck. Preoperatively, patients' demographics and characteristics were reported. The Mallampati score and thyromental distance in mouth opening were also recorded.In the operating room, standard monitoring was employed on all patients and, after pre-oxygenation, anaesthesia was induced with midazolam 0.02-0.04 lg.kg )1 , fentanyl 2-4 lg.kg, and propofol 1-2 mg.kg )1 . Neuromuscular blockade was achieved using rocuronium in a dose of 0.6 mg.kg )1 and an adequacy of neuromuscular block confirmed using a peripheral nerve stimulator. Patients were placed in the 'sniffing' position with their head on a pillow. If ventilation via face mask was considered inadequate by the anaesthesiologist, the patient was withdrawn from the study. Anaesthesia was maintained with either propofol or sevoflurane in oxygen during the study and analgesics agents administered according to preference. A standard Macintosh laryngoscope and TruView EVO2 laryngoscope were used throughout the study...

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

“…(2011) in their study found that the mean time to intubation was significantly shorter with the Macintosh laryngoscope than the Truview laryngoscope. 12,13,15 Thus, the result in our study was comparable to the above study. We experienced considerable difficulties in advancing the tracheal tube towards the view of the digital camera, a finding again previously reported by other investigators.…”

A Comparison of the Effects of Different Types of Laryngoscope on the Cervical Motions: Randomized Clinical Trial

“…Truview EVO2 ® laryngoscopes have been reported to have advantages in patients with a low risk of difficult intubation when compared to the Macintosh-type laryngoscope (12,13), whereas, in some case reports, patients with difficult intubation with Macintosh laryngoscopes have been reported to have successful intubations with Truview EVO2 ® -type laryngoscopes (14,15).…”

Direct and Indirect Laryngoscopy: Equipment and TechniquesDiscussion

“…Several studies have shown that this device produces superior laryngeal views and requires less force during laryngoscopy compared with a Macintosh laryngoscope blade. 54,55 Like other rigid fiberoptic laryngoscopes, it is robust and easily portable and can control soft tissue well during laryngoscopy. However, these devices have not gained widespread use in clinical practice.…”