Conventional Macintosh Laryngoscope Research Articles

Comparison of king vision video laryngoscope with macintosh laryngoscope for nasotracheal intubation: Randomized control study

Nasotracheal intubation is essential in oro-maxillofacial surgeries to provide a good operational field along with a secured airway. In this study, we aim to compare king vision video laryngoscope with conventional Macintosh laryngoscope for nasotracheal intubation in ear, nose throat and oro-maxillofacial surgeries under general anaesthesia. A total of 102 patients were posted for elective oro-maxillofacial surgeries under general anaesthesia with nasal intubation. Patients were randomized to two different groups. In group K nasotracheal intubation was done with king vision video laryngoscope (KVVL) and in group M with Macintosh laryngoscope. Primary objective was to compare total intubation time and each time intervals (time A: placement of the nasal tube from selected nostril to oropharynx; time B: use of devices to view the glottis, and time C: for nasal tube to be advanced from oropharynx into trachea and removal of the laryngoscope from oral cavity). Secondary objectives were to compare scores of Modified Naso Intubation Difficulty Scale (MNIDS) and haemodynamic responses.The mean total intubation time, and time C interval were noted in King Vision Video Laryngoscope group (37.29±7.83 s and 15.99±8.9 s) and Macintosh laryngoscope group (46.11±10.05 s and 19.86±9.96 s) respectively. There was significant difference between these two groups in terms of mean total intubation time, and time C interval (total time, p=0.001 and time C, p=0.041). The level of difficulty in intubation noted using MNIDS score which is zero in 52.9% patients in King Vision group and 23.5% in Macintosh group (p=0.011).As compared to Macintosh laryngoscope, the king vision laryngoscope requires lesser time for nasotracheal intubation. In addition, Intubation is easier with the king vision laryngoscope than with the Macintosh laryngoscope.

Comparison of grooved and conventional Macintosh laryngoscope blades for throat pack insertion: A randomized control trial

Abstract Background and Aims: Throat pack insertion is required for many otolaryngological surgeries under general anesthesia. To facilitate surgery, an oral Ring, Adair, and Elwyn (RAE) endotracheal tube is used. When the Macintosh blade is used to insert the pack, the tube often moves to the left as per its design. We designed a groove in the Macintosh laryngoscope blade to hold the endotracheal tube in place during pack placement. This study was done to compare the grooved and conventional Macintosh laryngoscope blades for throat pack insertion with respect to the intraoral movement of the tube, ease of packing, time taken, and associated hemodynamic changes in patients who have been intubated with a preformed oral endotracheal tube. Material and Methods: This randomized control trial included 80 patients after approval from the institutional ethics committee and CTRI. Informed written consent was taken from all patients. Packing of cases was done with either grooved (group G) or conventional Macintosh laryngoscope blade (group C). Student’s t-test, Chi-square test, and Mann–Whitney U test were used to analyze data. Results: The tube remained in the center in 35/40 patients in group G as compared to 10/40 patients in group C (P < 0.0001). Packing the throat was significantly easier (P = 0.005), and time taken to pack the throat was shorter in group G as compared to group C (P = 0.0008). Conclusions: The endotracheal tube remains in the center more often during throat pack insertion using a grooved laryngoscope blade as compared to the conventional Macintosh laryngoscope blade. The grooved blade is easier to use and takes less time to insert the throat pack.

Comparative evaluation of low-cost Macintosh video laryngoscope with conventional Macintosh laryngoscope: A randomized controlled trial

Comparative evaluation of low-cost Macintosh video laryngoscope with conventional Macintosh laryngoscope: A randomized controlled trial

A randomized comparison of the performance of Airtraq videolaryngoscope versus Macintosh laryngoscope in simulated rapid sequence induction of anaesthesia

Application of cricoid pressure during rapid sequence induction (RSI) of anaesthesia leads to difficult airway. No channeled videolaryngoscope (VL) has been compared with the Macintosh laryngoscope for facilitating intubation in RSI. Thus, we compared Airtraq® VL with Macintosh laryngoscope for simulated RSI in patients scheduled for elective surgeries.Following approval from Institutional Ethics Committee-Human Research, this randomized study was conducted. Patients of either sex, aged 18-65yr, ASA grade I/II, scheduled for elective surgeries under GA were included. 'Group DL' underwent direct laryngoscopy (DL) using Macintosh laryngoscope and Group VL with Airtraq® videolaryngoscope. Time taken for intubation, Cormack-Lehane (CL) grade of laryngeal view, number of intubation attempts, and haemodynamic parameters were noted. Student t-test and chi square test were used for statistical analysis.A total of 140 patients with 70 in each group were included. The mean time taken for intubation was significantly higher in VL group (84.70 ± 28.05s) than DL group (23.90 ± 6.67s). The optimal laryngeal view (i.e. CL grade I or II) was significantly improved in VL group than DL group i.e. 97% vs 94%. In group DL, 99% (n=69) were intubated in first attempt; whereas 60% (n=42) in Group VL (p<0.001). Hemodynamics was better in group VL.Airtraq® VL is better than conventional Macintosh laryngoscope for endotracheal intubation during RSI in terms of optimal glottic view, ease of intubation and haemodynamics. On the contrary, the “time taken to intubation” and the first attempt intubation rate were higher with Airtraq® VL.

A comparative study to evaluate the cervical spine movements during laryngoscopy using Macintosh and Airtraq laryngoscopes.

Intubation with Macintosh requires flexing the lower cervical spine and extending the atlanto-occipital joint to create a "line of sight." Primary aim of study was to compare the extent of cervical spine movement during laryngoscopy using conventional Macintosh laryngoscope and Airtraq. A total of 25 patients of either sex between the age group of 18 and 60 years, having American Society of Anesthesiologists (ASA) physical status of Grade-I and Grade-II, scheduled for elective surgery under image control requiring general anesthesia and intubation were enrolled. A baseline image of the lateral cervical spine including the first four cervical vertebrae was taken by an image intensifier. After administration of general anesthesia, laryngoscopy was first performed using a Macintosh laryngoscope and a second X-ray image of the lateral cervical spine was taken. The second laryngoscopy using a Airtraq laryngoscope was done and the third image of the lateral cervical spine was taken. Angles between occiput and C1; C1 and C2; C2 and C3; C3 and C4; and occiput and C4 were calculated. Atlanto-occipital distance (AOD) was calculated as the distance between occiput and C1. Macintosh showed greater cervical movement as compared with Airtraq but a significant difference in the movement was observed at C2-C3 and C0-C4. Baseline mean AOD was 2.21 ± 1.25 mm, after Macintosh and Airtraq laryngoscopy was found to be 1.13 ± 0.60 and 1.6 ± 0.78 mm, respectively, and was found to be significant (P < 0.05). We conclude that Airtraq allows intubation with less movement of the upper cervical spine makes Airtraq preferred equipment for intubation in patients with a potential cervical spine injury.

Comparing the usefulness of VividTrac and classic Macintosh laryngoscope in intubation in pediatric patients with cleft palate

BackgroundSurgical repair for pediatric patients with cleft palate is performed under general anesthesia requiring endotracheal intubation. However, intubating these cases is usually difficult because of the cleft itself and associated airway abnormalities. VividTrac, a video laryngoscopy that could provide a real-time picture of the glottic area, could be helpful in these cases.MethodsWe conducted the current prospective investigation to compare VividTrac and conventional Macintosh laryngoscope in intubating pediatric patients with cleft palate.ResultsAll patient demographics did not express significant differences between the two groups. The number of trials and the first trial success rate were in favor of group L. The former had mean values of 1.28 and 1.05, while the latter occurred in 81.4% and 97.7% of patients in groups L and V, respectively. Group V showed a significant increase in the time interval passing between mouth opening and connecting the tube with the ventilator.Nonetheless, the difficulty of intubation was increased in group L. The need for cricoid pressure and tube introducer was increased in group L.ConclusionsVividTrac laryngoscope could be a valid and more suitable option for intubation in pediatric patients with cleft palate. Compared to the conventional laryngoscope, it has a higher success rate, lower attempt number, and lower need for assisting maneuvers.

Comparing the learning curve of laryngoscopy using macintosh laryngoscope with or without video assistance for tracheal intubation by novices after manikin training

ObjectiveNo studies in the literature have compared video-assisted MacIntosh laryngoscope with conventional MacIntosh laryngoscope in teaching tracheal intubation to novices. Hence, we conducted a randomized controlled trial to compare the learning curve of direct MacIntosh laryngoscope with and without video assistance for tracheal intubation by novices after manikin training. MethodsTwelve novices were included in the study. Out of 12, six novices were taught tracheal intubation on manikin using a MacIntosh laryngoscope, and the other six using a video-assisted MacIntosh laryngoscope. In Group ML(n = 30), novices trained with MacIntosh laryngoscope performed tracheal intubation in 5 patients, each using the same device. In Group VML(n = 30), novices who were acquainted with video-assisted MacIntosh laryngoscope performed tracheal intubation in 5 patients, each using the same device. ResultsThe percentage of 0, ≤5, and >5 Intubation difficulty scale (IDS) were 0.00%, 43.33%, and 56.67% in Group ML and 0.00%, 80.0%, and 20.00% in Group VML, respectively. The success rate of performing tracheal intubation in Group ML was 40.00%(12/30), and the success rate of Group VML was 70.00%(21/30). The difference in the IDS score and success rate of intubation were found to be statistically significant. The mean intubation time was 93.77 ± 15.80 s in Group ML and 92.33 ± 19.06 s in Group VML. The visualization of the glottis by Cormack Lehane grading (CLG) in Group ML(n = 30) was grade I in 14(46.67%) patients and grade II in 16(53.33%) patients. In Group VML (n = 30), CLG grade I accounted for 18(60.00%) patients, grade II in 12(40%) patients. The intubation time and CLG were statistically insignificant between the two groups. ConclusionNovices trained and performed tracheal intubation with video-assisted MacIntosh laryngoscope had a greater success rate on the first attempt and lower IDS score than those trained with MacIntosh laryngoscope.

Anti-Toothbreaker: A Novel Low-Budget Device Enabling Contactless Dental Protection and a Forbidden Technique during Direct Laryngoscopy for Endotracheal Intubation

Iatrogenic dental injury is the most common complication of conventional laryngoscopy during orotracheal intubation. The main cause is unintended pressure and leverage forces from the hard metal blade of the laryngoscope. The aim of this pilot study was to introduce and test a novel, reusable low-budget device not only providing contactless dental protection during direct laryngoscopy for endotracheal intubation, but also enabling, in contrast to established tooth protectors, active levering with conventional laryngoscopes for easier visualization of the glottis. A constructed prototype for intrahospital usage was evaluated by seven participants on a simulation manikin for airway management. Endotracheal intubation was performed with and without the device using a conventional Macintosh laryngoscope (blade size 4) and a 7.5 mm endotracheal tube (Teleflex Medical GmbH, Fellbach, Germany). Necessary time and success of first pass were determined. Degree of visualization of the glottis with and without the device was stated by the participants according to the Cormack and Lehane (CL) classification system and the Percentage of Glottic Opening (POGO) scoring system. In addition, subjective physical effort, feeling of safety regarding successful intubation, and risk for dental injury were queried on a numeric scale between 1 and 10. All participants except one stated that the intubation procedure was easier with usage of the device than without it. On average, this was subjectively perceived as being approximately 42% (range, 15-65%) easier. In addition, time to first pass success, as well as degree of glottis visualization, subjective physical effort, and feeling of safety regarding risk for dental injury, were clearly better with usage of the device. Concerning feeling of safety regarding successful intubation, there was only a minor advantage. No difference in first pass success rate and number of total attempts could be observed. The Anti-Toothbreaker is a novel, reusable low-budget device which might not only provide contactless dental protection during direct laryngoscopy for endotracheal intubation, but also enables, in contrast to established tooth protectors, active levering with conventional laryngoscopes for easier visualization of the glottis. Future human cadaveric studies are needed to investigate whether these advantages also prove themselves there.

Comparison of the McGRATHTM Video Laryngoscope and Macintosh Laryngoscope for Orotracheal Intubation in a Simulated Difficult Airway Scenario: An Open-Label, Randomized Clinical Trial

Background and Objectives: Difficult intubation, which may be encountered unexpectedly during anesthesia, can increase patients' morbidity and mortality. The McGRATH video laryngoscope is known to provide improved laryngeal visibility in patients with difficult or normal airways. The purpose of this study was to evaluate the efficacy of the McGRATH video laryngoscope for orotracheal intubation compared with that of conventional Macintosh laryngoscopes in simulated difficult airway scenarios. Materials and Methods: In this randomized controlled trial, patients who were scheduled for surgery under general anesthesia requiring orotracheal intubation were assigned to the Macintosh laryngoscope (n = 50) or McGRATH video laryngoscope (n = 45) groups. In this study, to create a simulated difficult airway condition, the subjects performed manual in-line stabilization and applied a soft cervical collar. The primary outcome was the rate of successful intubation within 30 s. The time required for an intubation, glottis grade, intubation difficulty scale (IDS score), the subjective ease of intubation, and optimal external laryngeal manipulation (OLEM) were evaluated. In addition, complications caused by each blade were investigated. Results: The intubation success rate within 30 s was not significantly different between the two groups (44 (88.0%) vs. 36 (80.0%), p = 0.286). The glottic grade was better in the McGRATH group than in the Macintosh group (p = 0.029), but neither the intubation time (26.3 ± 8.2 s vs. 24.2 ± 5.0 s, p = 0.134) nor the rates of oral bleeding (2 (4.0%) vs. 0 (0.0%)) and tooth injury (0 (0.0%) vs. 1 (2.2%)) were significantly different between the two groups. Conclusions: The use of the McGRATH video laryngoscope did not improve the intubation success rate or shorten the intubation time. However, the McGRATH video laryngoscope provided a better glottis view than the conventional Macintosh laryngoscope in patients with a simulated difficult airway.

Comparative Preference of Airtraq Laryngoscope Over Macintosh Laryngoscope- A Review

Tracheal intubation using a Macintosh laryngoscope can save lives. However, because intubation is a difficult procedure to master, failures can have disastrous results. A more recent intubation tool than the Macintosh is the Airtraq optical laryngoscope, which offers glottic plane visualization without requiring correct tracheal, pharyngeal and oral axes alignment. Airtraq can improve the incidence of failed first intubations and the time required to manage an airway, especially in patients who have had cervical spine trauma which requires manual stabilization of the cervical spine. With no differences in hemodynamics or intubation duration, the Airtraq laryngoscope offered patients a better laryngeal vision than the Macintosh laryngoscope by providing shorter laryngoscopy and intubation time, and easier intubation. The aim of this literature review was to compare these two laryngoscopes with respect to endotracheal intubation. This review article was put together after a comprehensive study of the literature using the electronic databases PubMed, Medline, Embase and Google. Airtraq laryngoscope was found to be superior to Macintosh laryngoscope as it provides a better view of the glottic region with more ease and less intubation time than the conventional Macintosh laryngoscope.

Comparison of McGrath videolaryngoscope with conventional Macintosh laryngoscope for tracheal intubation in pediatric patients with normal airway

Background and Aims: Videolaryngoscopes have attained prime importance in securing the airway in children in the present era. McGrath videolaryngoscope is available with single-use non-channeled fog-free disposable blades of various sizes showing its efficacy for intubation in adults but still lacunae in data related to children.Materials and Methods: In this prospective randomized controlled trial, a total of 88 children of the American Society of Anesthesiologists Grade I and II aged 1–10 years, weighing 10–20 kg undergoing general anesthesia were enrolled. Using the sealed envelope technique, the children were randomly allocated between Group G, in whom McGrath videolaryngoscope and Group M, in whom Macintosh laryngoscope was used for intubation. The primary aim was to compare intubation time between the two videolaryngoscopes. The secondary outcomes included glottic exposure time, Cormack and Lehane grading, number of attempts of intubation, intubation difficulty scale and complications. Statistical analysis was done using MedCalc software. The Student's t-test and Chi-square test were used for quantitative and categorical data, respectively.Results: The mean intubation time was comparable in both the groups (18.14 ± 17.80 s in Group G vs. 17.30 ± 16.74 s in Group M, P = 0.821). The mean time to glottic exposure was shorter (5.66 ± 4.58 vs. 8.50 ± 5.59 s, P = 0.0108) with decreased number of attempts of tube insertion and less incidences of trauma observed in patients with Group G as opposed to Group M. The Cormack and Lehane grading showed better glottic view in Group G.Conclusion: McGrath videolaryngoscope is as useful as the Macintosh laryngoscope for intubation in children with the added advantages of a better view of the larynx, lesser attempts to intubation, and fewer incidence of trauma.

Comparing Postoperative Sore Throat (POST) Following Intubation using Macintosh Laryngoscope Versus C-MAC® Video Laryngoscope

Postoperative sore throat (POST) is a common complication with incidence of 30-90% when intubation was done using conventional Macintosh laryngoscope. Although POST is usually self-limiting and with no long-term morbidity, it can lead to patient’s discomfort and dissatisfaction in the postoperative period. The objective of this study was to compare the incidence of POST following intubation using Macintosh laryngoscope and C-MAC® videolaryngoscope (VL) at various time intervals post anaesthesia. This prospective randomised controlled study comprised of 128 patients with American Society of Anesthesiologists (ASA) I and II status who underwent elective surgery under general anaesthesia in Universiti Kebangsaan Malaysia Medical Centre. All recruited patients have normal airway and divided randomly into Group 1 and Group 2 that used Macintosh laryngoscope and C-MAC® VL during intubation, respectively. Patients were evaluated for sore throat, hoarseness of voice, dysphagia and coughing at recovery, 6 hours, 12 hours and 24 hours after intubation. Severity of POST was assessed using numerical rating scale (NRS). Incidence of POST was found to be higher in the Macintosh laryngoscope group (61.9%) compared to C-MAC® VL group (47.9%) although the difference was not statistically significant (p=0.107). Median pain score was used to assess the severity of POST, showing low and comparable in both groups at all time intervals. There were also no significant differences seen in hoarseness of voice, coughing and dysphagia for both groups during postoperation. Incidence of POST following intubation using C-MAC® VL and conventional Macintosh laryngoscope were comparable. This study revealed that severity of POST was generally low in both groups.

Comparing the Ease of Intubation between C-MAC, McGrath, and Conventional Macintosh Laryngoscope in a Simulated Difficult Airway of a Laerdal Mannequin

Tracheal intubation is an essential skill for doctors. Tracheal intubation is done in patients with questionable airway patency, poor respiratory drive, hypercarbia, or hypoxia. The objective of this study was to compare the ease of tracheal intubation using MacintoshLaryngoscopes, C-MAC, and McGrath on a simulated difficult airway mannequin. The rationale of the study was to identify the easiest device to use for tracheal intubation. This randomized clinical trial was done at the Teluk Intan Hospital, Perak, Malaysia, from March 2020 to February 2021. Sixty-five medical officers participated in this study. The results showed that the mean time for tracheal intubation was significantly shorter when the participants were using the C-MAC than the conventional direct laryngoscope and McGrath. (C-MAC: 20.8 seconds, Direct Laryngoscope: 27.7 seconds, McGrath: 34.6 seconds) The results showed that C-MAC andMcGrath had a better first-attempt success rate than conventional direct laryngoscopes. C-MAC scored the highest first-attempt success rate, followed by McGrath. (95% compared to 83%) Regarding Cormack-Lehane grading, the C-MAC device showed a better view than McGrath and Direct Laryngoscope. The preferred device by medical officers for tracheal intubation was the C-MAC. (45% compared to other devices) In conclusion, the C-MAC device was superior in first attempt success rate and was the most preferred device compared to McGrath and direct laryngoscope. However, using the C-MAC device must be accompanied by adequate training and practice.

Study of Video Assisted Laryngoscope versus Conventional Macintosh Laryngoscope for Management of Predicted Difficult Airway in Minor Elective Surgeries

Study of Video Assisted Laryngoscope versus Conventional Macintosh Laryngoscope for Management of Predicted Difficult Airway in Minor Elective Surgeries

Comparative Evaluation of King Vision Video Laryngoscope, McCoy and Macintosh Laryngoscopes in Patients Scheduled for Mucormycosis Surgery: A Randomised Clinical Trial

Introduction: Mucormycosis, an aggressive fungal infection may result in a difficult airway owing to its inflammation. King Vision Video Laryngoscope (KVVL) is a useful addition to a difficult airway armamentarium. McCoy laryngoscope with hinged tip is well-known equipment of difficult airway cart. Conventional Macintosh laryngoscope dominates in anaesthesia practice. Standard, existing and contemporary devices were compared in difficult airways resulting from mucormycosis. Aim: To compare the relative performance of KVVL, McCoy, and Macintosh laryngoscopes based on the ease of intubation and haemodynamic response in patients with mucormycosis. Materials and Methods: The present study was a randomised clinical trial done during June-August 2021 on 90 consenting patients of 18-65 years age, belonging to either sex with microbiologically confirmed mucormycosis undergoing debridement surgery. Group A was intubated with a non channeled KVVL, while group B had McCoy and group C had Macintosh laryngoscope. Primary outcome parameters were Cormack Lehane (CL) grade, time from laryngoscopy to successful intubation, number of attempts, any adjuncts or optimisation maneuvers, and any mucosal injury. Secondary outcome parameters were Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Blood Pressure (MBP) measured on arrival, before induction, after induction, and at 1, 2, 3, 5, and 7 minutes after intubation. Comparison of quantitative variables not normally distributed were analysed using Kruskal Wallis test. Post-hoc analysis by Dunn's multiple pairwise comparison test. Friedman test followed by pairwise comparison was done to compare haemodynamic parameters within each group. Chi-square test was used for qualitative variables. The p-value ≤0.05 was considered to be statistically significant. Results: CL grade was lowest in group B (1.83±0.38) against group A (1.93±0.25), group C (2.13±0.35) with p-value of 0.029. Time from laryngoscopy to successful intubation was the least in group B (19.5±3.98) against group A (26.07±9.8), group C (21.33±3.74) with p-value of 0.002. No significant difference was there in the number of attempts, airway adjuncts/optimisation maneuvers, mucosal injury. Haemodynamic variables were comparable. Conclusion: McCoy laryngoscope was found to perform best in difficult airways resulting from mucormycosis. It was most effective for glottic visualisation, with the shortest time to successful intubation and, haemodynamic parameters were comparable to KVVL and Macintosh laryngoscopes.

A Study of Effectiveness of Videolaryngoscopy and Conventional Laryngoscopy in Adult Patients for Orotracheal Intubation

Aim: Present study was carried out to evaluate and compare the laryngeal view and intubation by direct laryngoscopeusing macintosh blade with video laryngoscope in adult patients requiring endotracheal intubation.Material and Methods: This prospective study was carried out at our institute - GUJARAT CANCER SOCIETY MEDICALCOLLEGE, HOSPITAL AND RESEARCH CENTER. Total 100 adult patients for elective surgery under general anaesthesiawere included in this study. Patients were randomly divided in two groups. Each group included 50 patients. Group A:Videolaryngoscopy, Group B : Conventional Laryngoscopy. Hemodynamic changes and SpO2 were noted and recordedduring the procedure at various intervals.Results: Cormack Lehane glottis view is better with videolaryngoscope than conventional Macintosh laryngoscope andis significant statistically. The mean tracheal intubation time was higher, in Group B as compared to Group A. But thedifferences were statistically not significant. The mean rate of failure to intubate was almost similar among both thegroups. The difference was statically not significant. No statistically significant difference was observed in mean arterialBP between the two study groups, at any point time.Conclusion: video laryngoscope offers a better laryngeal view, minimum external maneuvers, less attempts for intubationand provides better hemodynamic response during laryngoscopy and intubation as compare to direct laryngoscopy withMacintosh blade.

Aerosol box for intubation of patients with suspected COVID-19: simulation study

Introduction. Endotracheal intubation is a procedure associated with a high level of exposure to the COVID-19 virus. This has led to the search of alternatives to reduce the risk of contamination, including the so-called aerosol box.&#x0D; Objective: To compare time and difficulty of orotracheal intubation when using the aerosol box in a simulated setting.&#x0D; Methodology: Observational study conducted with the participation of 33 anesthetist physicians and anesthesia residents; groups were compared in terms of time and intubation difficulty using a conventional Macintosh laryngoscope and the McGRATH™ MAC (Medtronic) videolaryngoscope with or without aerosol box. In order to determine performance with the intubation maneuver, crude hazard ratios were estimated, and a Cox multivariate regression model was built, adjusted by anesthetist years of experience and difficulties during the procedure.&#x0D; Results: On average, the aerosol box increased intubation time by 7.57 seconds (SD 8.33) when the videolaryngoscope was used, and by 6.62 (SD 5.74) with the Macintosh. Overall, 132 intubations were performed, with 121 successful and 6 failed first-time attempts (4 with the use of the aerosol box); 16 participants (48.48%) reported difficulty handling the box. With the use of the Macintosh, intubation was found to be faster than with the videolaryngoscope (cHR: 1.36 [95% CI 0.64-2.88]; adjusted HR: 2.20 [95% CI 0.73-6.62]).&#x0D; Conclusions: The use of the aerosol box and personal protective equipment in a simulation setting hinders the intubation maneuver and may result in protracted execution time.

Hemodynamic Response Following Endotracheal Intubation Using Intubating Laryngeal Mask Airway in Comparison with Conventional Macintosh Laryngoscope; A Prospective Randomised Controlled Trial

Hemodynamic Response Following Endotracheal Intubation Using Intubating Laryngeal Mask Airway in Comparison with Conventional Macintosh Laryngoscope; A Prospective Randomised Controlled Trial

A Comparative Study of Cormack Lehane Grading by Macintosh, McCoy and Video Laryngoscope in Patients with Predicted Normal Airway

Background: The conventional Macintosh laryngoscope is used most commonly due to its familiarity and ease of use. Newer devices like video laryngoscope are also being commonly now-a-days. Hence a comparative study of the 3 commonly used laryngoscopes has been done. Aims &amp; Objectives: To compare direct laryngoscope view of the different laryngoscope blades &amp; to find out the most suitable laryngoscope in patients with predicted normal airway. Methodology: 150 ASA grade I-II patients with 50 patients in each group were taken. Their stress response, CML grading &amp; intubation time were compared. Results: Stress response was least &amp; CML grading was best, however the time taken to intubate was maximum (P&lt;.001) with Video-laryngoscope as compared to McCoy &amp; Macintosh. Conclusion: Video-Laryngoscope provides better visualization of glottic opening as compared to Macintosh and McCoy with less stress response but being a newer device needs more expertise to intubate the patient. Keywords: Video-laryngoscope; Macintosh laryngoscope; CML; Tracheal intubation.

Video Laryngoscopy Improves Intubation Times With Level C Personal Protective Equipment in Novice Physicians: A Randomized Cross-Over Manikin Study.

The use of video laryngoscopes by novice physicians may improve first-pass success rates compared with direct laryngoscopy. The aim of the present study was to assess whether time to intubation, number of laryngoscopy attempts, and first-pass success rate during laryngoscopy with the video laryngoscope or conventional Macintosh laryngoscope are affected by personal protective equipment (PPE) donning. Seventy inexperienced physicians were randomly assigned to video laryngoscope or Macintosh groups and were instructed to perform intubation with both devices on a manikin, using PPE or a standard uniform. The primary outcomes were insertion time, number of laryngoscopy attempts, and first-pass success rates for each device with or without donning PPE. In the Macintosh group, significantly less time was needed for the first successful intubation without PPE vs. with PPE (12.17±3.69s vs. 24.07±5.09s, respectively; p<0.0001). On the other hand, such difference was not observed in the video laryngoscope group (14.99±3.01s vs. 14.01±3.35s, respectively; p=0.07). With PPE, the first-pass success rate was significantly higher in the video laryngoscope group [41 (58.6%) vs. 66 (94.3%), p<0.001]. The use of the video laryngoscope resulted in a significant decrease in insertion time compared with the Macintosh blade (14.01±3.35s vs. 24.07±5.09s, respectively; p<0.0001). First-pass success and insertion time with the video laryngoscope were not affected by PPE donning. However, both were negatively affected with the Macintosh laryngoscope.