Comparison of the Glidescope^®, the McGrath^®, the Airtraq^® and the Macintosh laryngoscopes in simulated difficult airways*

Abstract

Several indirect laryngoscopes have recently been developed, but relatively few have been formally compared. In this study we evaluated the efficacy and the usability of the Macintosh, the Glidescope Ò , the McGrath Ò and the Airtraq Ò laryngoscopes. Sixty anaesthesia providers (20 staff, 20 residents, and 20 nurses) were enrolled into this study. The volunteers intubated the trachea of a Laerdal SimMan Ò manikin in three simulated difficult airway scenarios. In all scenarios, indirect laryngoscopes provided better laryngeal exposure than the Macintosh blade and appeared to produce less dental trauma. In the most difficult scenario (tongue oedema), the Macintosh blade was associated with a high rate of failure and prolonged intubation times whereas indirect laryngoscopes improved intubation time and rarely failed. Indirect laryngoscopes were judged easier to use than the Macintosh. Differences existed between indirect devices. The Airtraq Ò consistently provided the most rapid intubation. Laryngeal grade views were superior with the Airtraq Ò and McGrath Ò than with the Glidescope

Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult Airways

“…In addition, it is difficult to obtain a standardized clinical environment in which many different anaesthesiologists can use different equipment. Anatomically correct manikins have been validated for this use and have been shown as a reliable surrogate marker of clinical situations (15,17,20,22). Secondly, our investigators were not blinded to the type of equipment that the participants used, and thus, there was a potential bias present.…”

“…i) Normal airway ii) Cervical spine immobilization with hard cervical collar and pharyngeal obstruction iii) Tongue edema Difficult laryngoscopy scenarios were selected among the configurations of difficult but feasible situations (16,17).…”

Tracheal intubation using the Airtraq®: a comparison with the lightwand

“…However, since the lightwand is a blind technique, it should be avoided in patients with known anatomical abnormalities of the upper airway such as tumours, polyps, infection, foreign bodies or upper airway trauma [14]. [2,15,16], and when used by both inexperienced and novice users [17,18]. The Airtraq also improved the intubation difficulty score and easy of use in patients with normal airways [14].…”

A randomised controlled trial comparing the McGrath® videolaryngoscope with the straight blade laryngoscope when used in adult patients with potential difficult airways*

“…The paraglossal straight blade and the videolaryngoscope have been shown in both manikin and human studies to improve the view of the larynx when compared with the Macintosh blade and to be useful in anticipated difficult airway management [3,[8][9][10]. However, no study has been performed comparing these two devices.…”