Tracheal intubation in patients with cervical spine immobilization: A comparison of McGrath ^® video laryngoscope and Truview EVO2 ^® laryngoscope

Abstract

Background and Aims:Literature suggests that glottic view is better when using McGrath® Video laryngoscope and Truview® in comparison with McIntosh blade. The purpose of this study was to evaluate the effectiveness of McGrath Video laryngoscope in comparison with Truview laryngoscope for tracheal intubation in patients with simulated cervical spine injury using manual in-line stabilisation.Methods:This prospective randomised study was undertaken in operation theatre of a tertiary referral centre after approval from the Institutional Review Board. A total of 100 consenting patients presenting for elective surgery requiring tracheal intubation were randomly assigned to undergo intubation using McGrath® Video laryngoscope (n = 50) or Truview® (n = 50) laryngoscope. In all patients, we applied manual-in-line stabilisation of the cervical spine throughout the airway management. Statistical testing was conducted with the statistical package for the social science system version SPSS 17.0. Demographic data, airway assessment and haemodynamics were compared using the Chi-square test. A P < 0.05 was considered significant.Results:The time to successful intubation was less with McGrath video laryngoscope when compared to Truview (30.02 s vs. 38.72 s). However, there was no significant difference between laryngoscopic views obtained in both groups. The number of second intubation attempts required and incidence of complications were negligible with both devices. Success rate of intubation with both devices was 100%. Intubation with McGrath Video laryngoscope caused lesser alterations in haemodynamics.Conclusions:Both laryngoscopes are reliable in case of simulated cervical spine injury using manual-in-line stabilisation with 100% success rate and good glottic view.

Comparison of Direct and Video Laryngoscopes during Different Airway Scenarios Performed by Experienced Paramedics: A Randomized Cross-Over Manikin Study

“…Bag et al found the mean time necessary for intubation equaled 21.10 ± 5.64 seconds for Truview and 15.79 ± 2.76 seconds for Macintosh [11]. A clinical study conducted by Bhola et al comparing McGrath and Truview PCD reported that the time to successful intubation was shorter with the McGrath video laryngoscope when compared with Truview (30.02 seconds versus 38.72 seconds) but there was no significant difference between the laryngoscopic views obtained in both groups [15]. Singh et al published the results of their study on intubation using Truview PCD, C-MAC, and Macintosh laryngoscopes in paediatric patients.…”

A comparison of direct laryngoscopy to video laryngoscopy by paramedic students in manikin-simulated airway management scenarios

“…The intubation times recorded in our study were similar to that found in previous studies for inexperienced providers, uncomplicated ETI and ETI with MILNS. Bhalla et al [5] prospectively compared the use of the McGarth and Truview VL systems in patients with MILNS applied throughout airway management in the operating room. The authors reported mean intubation times ranging between 30.02 and 38.72 s for the respective devices.…”

“…However, VL utilises a different psychomotor skill-set compared to DL, requires specific training [4] and familiarisation with the specific VL system itself. This can be argued as shown by the variability of performance between devices [5] , [6] , [7] . This is a concern in paramedic educational programs, as dilution of DL practice through the overuse of VL may result in DL skills attrition, which remains the standard rescue airway management option of choice when VL is not successful [8] .…”

Comparison of Airtraq and Trueview EVO2 with Macintosh Laryngoscope for Endotracheal Intubation by Experienced Anaesthesiologists: A Controlled Clinical Trial

“…More patients (16/50) required additional manoeuvres to improve glottis view in group ML than other groups. Improvement in Cormack and Lehane grade at least by one has been reported during both routine and difficult airway scenarios [13][14][15][16] while laryngoscopy with Airtraq and Trueview laryngoscopes.…”