Nociceptive stimulation during Macintosh direct laryngoscopy compared with McGrath Mac videolaryngoscopy

Ing, Rathvirak; Liu, Ngai; Chazot, Thierry; Fessler, Julien; Dreyfus, Jean François; Fischler, Marc; Guen, Morgan Le

doi:10.1097/md.0000000000008087

Cited by 6 publications

(3 citation statements)

References 28 publications

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“…In comparison to Macintosh, the needed force to visualize the laryngeal opening is lesser and the applied pressure on tongue base is more uniformly distributed with video laryngoscopes. [20] In this study, insignificantly more frequent airway trauma and sore throat were encountered with Macintosh. This may be related to the relatively greater force required to visualize the laryngeal opening.…”

Section: Discussionmentioning

confidence: 66%

Endotracheal intubation criteria and stress response: Airtraq versus macintosh laryngoscopes – A prospective randomized controlled trial

Abdallah

Gaballah

2019

Anesth Essays Res

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Background:Airtraq® is a single-use video laryngoscope used to facilitate tracheal intubation in both expected and unexpected difficult airways.Aims:We hypothesized that Airtraq laryngoscope would facilitate better intubation criteria and lower stress response to laryngoscopy in comparison to the Macintosh laryngoscope.Materials and Methods:In this randomized, single-blinded, prospective study, 70 adult patients were randomly assigned to be intubated with either Airtraq (Group AT) or Macintosh (Group M) laryngoscope (35 patients in each). The primary outcomes involved intubation time, first-attempt success rate, time to best laryngoscopic view, and percentage of glottic opening (POGO) score. Other recorded parameters involved the hemodynamic and intraocular pressure (IOP) responses to laryngoscopy and intubation and complications during and after laryngoscopy and after extubation. Serum samples were collected before anesthesia induction and 2 min after intubation and analyzed for epinephrine, cortisol, and glucose.Results:Group AT had significantly higher POGO score and significantly shorter intubation time and time to best laryngoscopic view than Group M (P < 0.001). The first-attempt success rate was 97.1% in Group AT and 94.3% in Group M (P = 0.55). Postoperatively, laryngospasm and sore throat were encountered in 2.9% of Group M patients compared to 0% in Group AT (P = 1.00). The heart rate, mean arterial pressure, IOP, serum epinephrine, and cortisol were significantly increased in Group M than Group AT.Conclusion:In comparison to the Macintosh laryngoscope, Airtraq conferred significantly better intubation criteria and lesser stress response to laryngoscopy and intubation.

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Section: Discussionmentioning

confidence: 66%

Endotracheal intubation criteria and stress response: Airtraq versus macintosh laryngoscopes – A prospective randomized controlled trial

Abdallah

Gaballah

2019

Anesth Essays Res

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“…As postoperative sore throat is usually self-limiting and improves within a week, it is generally considered as a minor complication. The incidence of postoperative sore throat after McGrath® MAC videolaryngoscopic intubation was reported to be 5–45.4% [7, 12–18], and its causes were multifactorial. In this study, when McGrath® MAC videolaryngoscope with size 3 MAC blade was used for tracheal intubation, no significant difference in the incidence of postoperative sore throat was observed between patients with the use of a malleable “hockey-stick” curved stylet and those without.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies reported that the incidence of postoperative sore throat after McGrath® MAC videolaryngoscopic intubation with a stylet was 9–45.4% with an average of about 25% [12–15]. To test the ability of McGrath® MAC videolaryngoscopic intubation without a stylet to reduce this incidence to 5%, at least 49 patients were enrolled in each group, based on an alpha of 0.05 (two-tailed) and a beta of 0.2.…”

Section: Methodsmentioning

confidence: 99%

Postoperative sore throat and subglottic injury after McGrath® MAC videolaryngoscopic intubation with versus without a stylet in patients with a high Mallampati score: a randomized controlled trial

Yoon

Lee

et al. 2019

BMC Anesthesiol

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Background A tracheal tube stylet can be used to assist successful tracheal intubation, especially during videolaryngoscopic intubation because videolaryngoscopes with a Macintosh-type blade such as McGrath® MAC videolaryngoscope have more acute angle than conventional Macintosh laryngoscope. However, the use of a stylet during tracheal intubation can raise concerns about stylet-induced postoperative airway complications, such as sore throat, subglottic injury, and hoarseness. In this study, we compared the incidence of postoperative airway complications after McGrath® MAC videolaryngoscopic intubation with versus without a stylet in patients with a high Mallampati score. Methods In 104 patients with Mallampati score III or IV and who were scheduled for lumbar or thoracic spine surgery, McGrath® MAC videolaryngoscopic intubation was performed either with a stylet (group S, n = 52) or without a stylet (group N, n = 52). The primary outcome measure was the incidences of sore throat evaluated at 1 and 24 h postoperatively. Secondary outcome measures were the incidences of subglottic injury and postoperative hoarseness. Results The incidence of CL grade III in group S and N was 3.8 and 5.8%, respectively. No patient showed CL grade IV. The incidences of sore throat at 1 (26.9 vs 19.2%, P = 0.485) and 24 h (17.3 vs 13.5%, P = 0.786, respectively) postoperatively were not significantly different between the group S and N. However, the incidence of subglottic injury was significantly higher in the group S, compared with the group N (65.4 vs 42.3%, P = 0.030). The incidence of postoperative hoarseness did not differ significantly between the two groups. Conclusions The use of a stylet during McGrath® MAC videolaryngoscopic intubation did not have a significant impact on the incidence of postoperative sore throat in patients with a high Mallampati score. Avoiding the use of a stylet during intubation with McGrath® MAC videolaryngoscope may reduce the incidence of subglottic injury in such patients. Trial registration Clinical Research Information Service (identifier: KCT0002427 , date of registration: June 12, 2017).

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Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation

Lewis

Butler

Parker

et al. 2016

Cochrane Database of Systematic Reviews

248

250

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Videolaryngoscopes may reduce the number of failed intubations, particularly among patients presenting with a difficult airway. They improve the glottic view and may reduce laryngeal/airway trauma. Currently, no evidence indicates that use of a VLS reduces the number of intubation attempts or the incidence of hypoxia or respiratory complications, and no evidence indicates that use of a VLS affects time required for intubation.

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Nociceptive stimulation during Macintosh direct laryngoscopy compared with McGrath Mac videolaryngoscopy

Abstract: Supplemental Digital Content is available in the text

Cited by 6 publications

References 28 publications

Endotracheal intubation criteria and stress response: Airtraq versus macintosh laryngoscopes – A prospective randomized controlled trial

Endotracheal intubation criteria and stress response: Airtraq versus macintosh laryngoscopes – A prospective randomized controlled trial

Postoperative sore throat and subglottic injury after McGrath® MAC videolaryngoscopic intubation with versus without a stylet in patients with a high Mallampati score: a randomized controlled trial

Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation

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