Intubation Conditions Research Articles

Comparison of mivacurium and rocuronium in the microsurgery of the larynx

Introduction: The introduction of sugammadex has created new opportunities for a quick reversal of relaxation caused by steroid relaxants. Aim: The objective of this study was to compare relaxation of striated muscles in laryngeal microsurgery depending on the applied agent: mivacurium or rocuronium. Material and methods: 65 low-risk surgery patients were randomly divided into two groups: MIV (n = 32) and ESM (n = 33) before the scheduled larynx microsurgery. The MIV group used mivacurium to relax the muscles, the ESM group used rocuronium.The following parameters were monitored: pulse rate, arterial blood pressure, arterial blood saturation, ventilation parameters according to the conventional standards and the depth and rate of neuromuscullar blockade (NMB) reversal. The demand for anesthetics and analgesics used during the anesthesia and the frequency of complication occurrence were evaluated. Results and discussion: There were no differences under intubation conditions. The conditions of the operation assessed by its operator were better in the ESM group. The time of the operation was similar in the two groups. The acting time of sugammadex in the ESM group was on average 1 minute. The ESM group reached train-of-four ratio (TOFR) of 0.9 (90% recovery of NMB) far more quickly than the MIV group. There was no statistical difference in side effects. Conclusions: It seems to be reasonable to replace mivacurium with rocuronium and reverse its action by means of sugammadex in patients with a positive family history of allergy and anaesthetized for short-term operations or operations of unpredictable duration.

Airway management in patients with cleft lip and palate: Evaluation of intubation conditions with videolaryngoscopy

Airway management in patients with cleft lip and palate: Evaluation of intubation conditions with videolaryngoscopy

Rapid Sequence Induction With a Standard Intubation Dose of Rocuronium After Magnesium Pretreatment Compared With Succinylcholine: A Randomized Clinical Trial.

BACKGROUND:Succinylcholine remains the muscle relaxant of choice for rapid sequence induction (RSI) but has many adverse effects. High-dose rocuronium bromide may be an alternative to succinylcholine for RSI but recovery times are nearly doubled compared with a standard intubating dose of rocuronium. Magnesium sulfate significantly shortens the onset time of a standard intubating dose of rocuronium. We set out to investigate whether intravenous (IV) pretreatment with MgSO4 followed by a standard intubating dose of rocuronium achieved superior intubation conditions compared with succinylcholine.METHODS:Adults were randomized to receive a 15-minute IV infusion of MgSO4 (60 mg·kg–1) immediately before RSI with propofol 2 mg·kg–1, sufentanil 0.2 μg·kg–1 and rocuronium 0.6 mg·kg–1, or a matching 15-minute IV infusion of saline immediately before an identical RSI, but with succinylcholine 1 mg·kg–1. Primary end point was the rate of excellent intubating conditions 60 seconds after administration of the neuromuscular blocking agent and compared between groups using multivariable log-binomial regression model. Secondary end points were blood pressure and heart rate before induction, before and after intubation, and adverse events up to 24 hours postoperatively.RESULTS:Among 280 randomized patients, intubating conditions could be analyzed in 259 (133 MgSO4-rocuronium and 126 saline-succinylcholine). The rate of excellent intubating conditions was 46% with MgSO4-rocuronium and 45% with saline-succinylcholine. The analysis adjusted for gender and center showed no superiority of MgSO4-rocuronium compared with saline-succinylcholine (relative risk [RR] 1.06, 95% confidence interval [CI], 0.81-1.39, P = .659). The rate of excellent intubating conditions was higher in women (54% [70 of 130]) compared with men (37% [48 of 129]; adjusted RR 1.42, 95% CI, 1.07-1.91, P = .017). No significant difference between groups was observed for systolic and diastolic blood pressures. Mean heart rate was significantly higher in the MgSO4-rocuronium group. The percentage of patients with at least 1 adverse event was lower with MgSO4-rocuronium (11%) compared with saline-succinylcholine (28%) (RR 0.38, 95% CI, 0.22-0.66, P < .001). With saline-succinylcholine, adverse events consisted mainly of postoperative muscle pain (n = 26 [19%]) and signs of histamine release (n = 13 [9%]). With MgSO4-rocuronium, few patients had pain on injection, nausea and vomiting, or skin rash during the MgSO4-infusion (n = 5 [4%]).CONCLUSIONS:IV pretreatment with MgSO4 followed by a standard intubating dose of rocuronium did not provide superior intubation conditions to succinylcholine but had fewer adverse effects.

Evaluation of the True View PCD Video Laryngoscope for Oral Endotracheal Intubation

Background: Truview PCD video laryngoscope is particularly planned to assist in locating the endotracheal tube in addition to observe the admission of the tube into the glottis. The present study was performed to assess the outlook of glottic opening and relief of intubation between the Truview PCD laryngoscope and Macintosh laryngoscope in patients undergoes general anaesthesia. Subjects and Methods: Ninety patients of ASA grade 1 and 2 aged 18-60 years, posted for elective surgery under general anaesthesia needing endotracheal intubation were arbitrarily allocated into group 1 (Truview PCD laryngoscope n=45) and group 2 (Macintosh laryngoscope n=45). The two groups were compared for demographic data, intubation difficulty score, Cormack-Lehane grade, time to intubate, number of intubation attempts and hemodynamic parameters. Conclusion: Truview PCD can be measured as an alternate intubation device, especially in difficult intubation conditions.

Improving mucosal anesthesia for awake endotracheal intubation with a novel method: a prospective, assessor-blinded, randomized controlled trial

BackgroundTopical anesthesia is a crucial step in awake endotracheal intubation for providing favorable intubation conditions. The standard of care technique for awake intubation at our institution, which consists of oropharyngeal tetracaine spray, can result in inadequate mucosal anesthesia. Therefore, we sought to compare the effectiveness of dyclonine hydrochloride mucilage to the standard of care tetracaine in achieving anesthesia of the upper airways for awake endotracheal intubation.MethodsThis is a randomized, assessor-blinded, prospective study. From Jun. 1st, 2019 to Aug. 1st, 2019, patients scheduled for either endoscopic submucosal dissection or peroral endoscopic myotomy were enrolled and randomly allocated into two groups after obtaining written informed consent: patients allocated to novel awake intubation care (Group N-AIC) received a single administration of oral dyclonine hydrochloride mucilage, whereas patients allocated to standard awake intubation care (Group S-AIC) received three oropharyngeal tetracaine sprays before transcricoid tetracaine injection before awake intubation. Mean arterial pressure (MAP), which was the primary outcome of this study, as well as heart rate (HR) were recorded throughout the procedure and compared between the two groups. Feeling of numbness, nausea, and intubation conditions after topical anesthesia were also assessed.ResultsSixty patients were enrolled and completed the study. Baseline MAP and HR were similar between the two groups. However, hemodynamic responses to intubation and gastrointestinal endoscopy, especially MAP, were significantly less elevated in Group N-AIC. The degree of numbness of the oropharyngeal mucosa after topical anesthesia did not differ between the two groups, neither did the feeling of nausea during laryngoscopy. The amount of pharyngeal secretions before intubation was less in Group N-AIC. Total intubation time was significantly shorter in Group N-AIC when compared to Group S-AIC (18.4 ± 2.86 vs. 22.3 ± 6.47, P < 0.05). Extubation bucking was significantly less frequent in Group N-AIC (13.3% vs. 76.7%). Patients received in Group N-AIC had a lower rate of post-extubation sore throat compared to Group S-AIC (6.7% vs. 43.3%). No adverse side effects attributable to either tetracaine or dyclonine were observed in this study.ConclusionsIn awake endotracheal intubation, novel care using oral dyclonine hydrochloride mucilage can provide more favorable mucosal anesthesia and better intubation conditions compared to standard of care practice using oropharyngeal tetracaine spray.Trial registrationChiCTR1900023151. Date of registration: May 14th, 2019.

Airway Blocks Vs LA Nebulization- An interventional trial for Awake Fiberoptic Bronchoscope assisted Nasotracheal Intubation in Oral Malignancies.

Background:Patients with intra-oral malignancies warrants use of awake Fiberoptic assisted naso-thracheal intubation to secure an airway due to multiple risk factors leading to anticipated difficult airway. Different techniques such as airway blocks, local anesthesia (LA) gargles, spray, nebulization and mild sedation are in practice to improve the success rate of fiberoptic assisted intubation. Methods:Sixty patients of ASA I and II with Mallampatti score 3 and above, posted for Commando operations were enrolled in this study and were divided into 2 groups. Group AB (Airway Block, n=30) were given Superior laryngeal nerve block bilaterally and recurrent laryngeal nerve block transtracheally with Inj 2% Lignocaine. Second Group AN (Airway Nebulization, n=30) patients airway was nebulized with 4% Lignocaine with ultrasonic nebulizer. After confirmation of satisfactory anesthesia clinically Fiber-optic assisted naso-tracheal intubation was attempted. Hemodynamic monitoring, total time taken for intubation, patients comfort and any complications occurred were noted. Statistical Analysis– All the observed values were tabulated and analyzed using software SPSS version 17.0. Results:Demography and Hemodynamic observations were comparable in the groups. The time taken for intubation, patient comfort score, intubation conditions were excellent in AB group than in group AN. Airway complications like laryngospasm and cough were noted in AN Group. Conclusions:Judicial use of combined Airway blocks such as Bilateral Superior and trans-tracheal recurrent laryngeal nerve blocks could facilitate a successful fiber-optic assisted awake naso-tracheal intubation in anticipated difficult intubation with negligible complications.

Assessment of endotracheal intubation procedures following inadvertent esophageal intubation. A randomized crossover manikin trial

Abstract&#x0D; Objective: To evaluate the success, degree of difficulty and completion time of endotracheal intubation without removing the endotracheal tube in the event of an oesophageal intubation.&#x0D; Methods: The prospective, randomised crossover study was conducted at Gulhane Training and Research Hospital, Ankara, Turkey, from July 1, 2018, to August 31, 2018, and used a manikin model. Endotracheal intubation was performed using Miller, Macintosh blades and a video laryngoscope. The procedures were randomised into two groups, with group E+ being subjected to it while an endotracheal tube ETT was placed in the oesophagus (E+) simulating the oesophageal intubation, and control group E- getting the standard procedure without the endotracheal tube in the oesophagus. All methods were evaluated for their success, completion time, and degree of difficulty. Data was analysed using SPSS 22.&#x0D; Results: There were 120 manikins, with 60(50%) in each of the two groups. The mean completion time with Miller in E+ group was 19.05±9.65 and for E- it was 17.55±11.95 seconds. With Macintosh, E+ had a mean completion time of 19.85±12.66 seconds and E- had 16.75±8.66. With video laryngoscope, E+ group had a mean completion time of 16.75±8.66 seconds, while E- had it 14.60±8.17. No significant difference was found in the paired group comparisons in terms of the degree of task difficulty (p&gt;0.05).&#x0D; Conclusion: In case of inadvertent oesophageal intubation condition, leaving the tube in the oesophagus and performing subsequent endotracheal intubation attempts was not found to decrease the rate of success regardless of the laryngoscope type.&#x0D; Continuous… &#x0D;

VieScope® laryngoscope versus Macintosh laryngoscope during difficult intubation performed by paramedics: a randomized cross-over manikin trial

INTRODUCTION: The aim of this study was to evaluate intubation performance by paramedics using Macintosh laryngoscope and VieScope® laryngoscope under simulated difficult airway conditions. METHODS: In a randomized, single-blinded, cross-over simulation trial, 42 paramedics performed endotracheal intubation using VieScope® and Macintosh (MAC) laryngoscopes in two difficult airway scenarios: (A) tongue edema, (B) manual cervical inline stabilization. The order of participants and intubation methods was random. Time to ventilation constituted the primary outcome, and the secondary outcomes were the success rate of first intubation attempt, overall intubation success rate, Cormack and Lehane grade, and ease of use. RESULTS: In scenario A, the median overall intubation time was 55s (46–109) in the MAC group and 30.5s (26–35) in the VieScope® group (p < 0.001). The efficacy of the first intubation attempt with MAC and Vie- Scope® varied and amounted to 64.3% vs. 95.2% (p < 0.001). During scenario B, VieScope® offered better intubation conditions than MAC (p < 0.001), including shorter intubation time, higher first attempt and overall intubation success rates, as well as better glottic view. CONCLUSIONS: In this simulation trial, we found that VieScope® could be successfully used for intubation in difficult airways by paramedics with little simulation experience with this device. VieScope® was associated with shorter time and higher success rates of intubation attempt compared with MAC. Nevertheless, we recommend that the performance of VieScope® and MAC should be further evaluated in the clinical setting to confirm our results.

LOCALANAESTESIA FOR AWAKE FIBEROPTIC INTUBATION: A COMPARISON OF TWO TECHNIQUES- AIRWAY NERVE BLOCKS VS 'SPRAY AS YOU GO' TECHNIQUE

Background- Awake fiberoptic intubation is the recommended technique for anticipated difficult airway management which requires effective local anesthesia for patient's comfort and co-operation. In this study, we compared airway nerve blocks and “Spray as you go” technique for awake fiberoptic intubation in difficult airway patients. Method- Sixty adult patients with an anticipated difficult airway with Mallampati Class III and IV were selected and randomized into two groups for awake fiberoptic intubation. Each group receiving lignocaine as a local anesthetic with either of two different methods. Group A (n=30) via airway nerve blocks using transtracheal and superior laryngeal nerve block; and group B (n=30) via intubating fiberscope using ‘spray as you go’ technique. We compared two groups using the Number of attempts for intubation, Intubation time, Intubating conditions, Cough count, Hemodynamic response, Severity scale [patients comfort], and the additional required dose of lignocaine used. Descriptive statistics were done for all data. p-value&lt;0.05 was considered statistically significant. The result- we found that airway nerve blocks provide better local anesthesia by providing good intubating conditions with less cough count, less intubation time, and better hemodynamic stability as compare to spray as you go group. None of the patients showed any evidence of lignocaine toxicity. But an additional dose of lignocaine used was significantly more number of patients in the spray as you go, group. However patient comfort and acceptance is equal in both groups as patient severity score was the same in both groups and all patients got successfully intubated in both the groups Conclusion- airway nerve block technique of local anesthesia is better than spray as you go method however spray as you go technique can be used in cases where airway blocks are not possible.

Precision Neuromuscular Block Management for Neural Monitoring During Thyroid Surgery

Introduction Titration of neuromuscular block (NMB) plays a key role in intraoperative recurrent laryngeal nerve monitoring during thyroid surgery. The combination of neuromuscular blocking agent and timely partial reversal of NMB was investigated in both animal experiments and clinical neuro-monitored thyroidectomy. Methods In animal experiments, 8 piglets received sugammadex to assess the laryngeal EMG recovery after rocuronium-induced NMB. In clinical monitored thyroidectomy, 40 patients each were allocated to conventional group and sugammadex group. Conventional group received rocuronium 0.3 mg/kg at anesthesia induction, while sugammadex group received partial NMB recovery protocol- 0.6 mg/kg of rocuronium at anesthesia induction and 0.5 mg/kg of sugammadex. Main outcome was assessed by first (V1) and final (V2) EMG signal induced by vagal stimulation. Results In the porcine model, 50% recovery of laryngeal EMG amplitude was achieved at 16.8 ± 1.9 and 6 ± 2.7 minutes respectively after 0.5 and 1 mg/kg of sugammadex (p < 0.01). In monitored thyroidectomy, EMG amplitudes at V1 in group S and group C were 1214 ± 623 and 915 ± 476 μV, respectively (p = 0.02). Positive and adequately high EMG amplitudes were observed at the early surgical stage for all patients. Sugammadex groups were superior to conventional group in EMG tube placement (p < 0.001). Conclusion Both porcine model and clinical application showed that precise NMB management by low-dose sugammadex was effective for intraoperative neural monitoring (IONM). The regimen ensured optimal conditions for tracheal intubation and timely neuromuscular function restoration for high-quality EMG signal.

Anaesthesia and orphan disease: A patient with neuromyotonia undergoing single lung ventilation.

Anaesthesia and orphan disease: A patient with neuromyotonia undergoing single lung ventilation.

In Response.

In Response.

HELP-VDL: study protocol for a multicentre, open, randomised, controlled clinical trial comparing the use of the head-elevated laryngoscopy position and the use of a videolaryngoscope to facilitate orotracheal intubation in a patient population without predictable difficulty of intubation

IntroductionTracheal intubation remains an everyday challenge for anaesthesiologists, even in patients without suspected difficult airways. The ideal positioning of the patient’s head (flat, raised a few centimetres on a cushion...

Oral surgery with nasotracheal intubation in a patient with ectodermal dysplasia

Ectodermal dysplasiasare a rare group of heritable disorders involving theectodermalderivatives with only a few published reports involving its anaesthetic management. We present the case of a 16-year-old boy with ectodermal dysplasia presented for elective oral surgery under general anaesthesia with a surgeon preference for nasotracheal intubation to provide adequate surgical exposure. The patient had successful nasal flexible bronchoscopic intubation despite challenging tracheal intubation conditions. We summarise previous case reports and discuss anaesthetic considerations in ectodermal dysplasia , including reduced mucus production in the respiratory tract, laryngeal incompetence, potential for difficult tracheal intubation and hyperthermia from reduced or absent sweat glands.

Comparison of Rocuronium and Succinylcholine for Rapid Sequence Induction in patients undergoing surgery under General Anaesthesia

Objectives: To compare the frequency of excellent intubation condition with Succinylcholine and rocuronium for rapid sequence induction in patients undergoing surgery under general anesthesia.&#x0D; Design: Randomized control trial.&#x0D; Place and duration of study: Department of anesthesiology and pain medicine, Combined Military Hospital Malir Cantt Karachi from 25th June to 10th August 2019.&#x0D; Methodology: In this randomized control trial, a non-probability consecutive sampling technique was used. Anesthesia was given through a standard approach. Then patients were randomly divided into two equal groups. In group A, succinylcholine (1mg/Kg) was given while in group B, rocuronium (1mg/Kg) was given. Laryngoscopy was attempted after 60 seconds. Intubating conditions were labeled as excellent, good, poor, and impossible. All the data was collected in two groups, the data was entered and analyzed on SPSS version 21.&#x0D; Results: The mean age of the patients was 40.11±9.49 years. The male to female ratio of the patients was 0.7:1. The study results showed the excellent intubation conditions were noted in 11 from group A and 9 from group B, good intubation condition was noted in 29 from group A and 25 from group B, poor conditions were noted in 17 from group A and 16 from group B and the impossible intubation conditions were noted in 13 from group A and 20 from group B. Statistically insignificant difference was found between the study groups with intubation conditions i.e. p-value=0.570.&#x0D; Conclusion: It has been proved in our study that both the succinylcholine and rocuronium are statically equally effective in terms of excellent intubation conditions in the management of rapid sequence induction in patients undergoing surgery under general anesthesia.

ASSESSMENT OF ROCURONIUM EFFECTIVENESS FOR PAITENTS

The study is based on succinylcholine which is a routine muscle relaxant for pediatric patients. Rocuronium is newer non depolarizing muscle relaxant. The objective of this study was to assess time, course and duration of both relaxants as well as intubation conditions. This study was blind and randomized in nature and conducted to test the intubating conditions with two separate kind of muscle relaxants in 50 ASA grade I and II pediatric patients who fall in age category of 2 to 6 years who undergone surgery of less than half an hour. Patients were anaesthetized with injection rocuronium 0.9 mg/kg i.v. or with injection succinylcholine 1.5 mg/kg after injection fentanyl 1ug/kg and injection thiopentone 5 mg/kg. The assessment of Neuromuscular blockade was conducted with twitch response of adductor pollicis longus after supra-maximal stimulation of ulnar nerve. We assessed Tracheal intubating conditions using the blinded anesthetist after 1 month and every 15 seconds till patient got intubated. The time of onset and percentage of neuromuscular blockage was also assessed.

Does infrared red intubation system improve the fibreoptic intubation conditions? A randomised control trial

Does infrared red intubation system improve the fibreoptic intubation conditions? A randomised control trial

To evaluate the efficacy of dexmedetomidine infusion versus fentanyl infusion for sedation during awake fibreoptic intubation (AFOI)

Awake fibreoptic intubation (AFOI) is a great aid in an anticipated difficult airway like in maxillofacial surgeries. For providing patient’s comfort and cooperation various drugs are used. In this study we evaluated efficacy of Dexmedetomidine and Fentanyl for sedation during AFOI.It is randomized prospective double blind study. It was conducted on patients electively posted for maxillofascial surgery. 60 patients were randomly divided in two groups. Group D received Dexmedetomidine 1µg/kg and Group F received Fentanyl 2µg/kg over 10 minutes. Patients from both groups were prepared with intravenous glycopyrrolate0.2mg and nebulization with 4% lidocaine 4ml. Nasal AFOI was performed with spray (10% lidocaine) as you go technique. Parameters analysed are intubation score by cough score and vocal cord movement, post intubation score, Ramsay sedation score, hemodynamics with incidence of desaturation. Also satisfaction score and time taken for intubation were compared in 2 groups.Cough score, vocal cord movement, postintubation score, Ramsay Sedation Score (RSS), patient satisfaction score were favourable in dexmedetomidine group without much difference in time taken for intubation in both groups. Minimum hemodynamic response (p value&amp;#60;0.05) with less oxygen desaturation (p value&amp;#60; 0.05) is seen in dexmedetomidine group.Dexmedetomidine appeared to offer better intubation condition, better tolerance to intubation with higher patient satisfaction and hemodynamic stability. Also it provides adequate sedation without desaturation making it more effective for AFOI than fentanyl.

Comparison of the effect of cisatracurium with or without magnesium pretreatment on neuromuscular blockade and hemodynamics, in cardiac surgery patients on cardiopulmonary bypass at SMS medical college

An ideal neuromuscular blocking agent should have a high degree of potency, rapid onset of action and short duration of action. It should not cause haemodynamic changes through releasing histamine, ganglion block, anti-muscarinic effects on heart or sympathomimetic action.This study was designed to compare the effect of cisatracurium with or without magnesium pretreatment on neuromuscular blockade and hemodynamics in cardiac surgery patients on cardiopulmonary bypass with objective to assess and compare intubation conditions and timing of intubation in minutes and assess and compare clinical duration of blockade, haemodaynamics variable and side effect if any.Hospital based, prospective, randomized double blind observational study. Total 60 patients included in the study (30 in each group). Group A Pretreatment with mgso 4(50mg/kg BW in 100ml NS 10 mints before general anesthesia (GA) and muscle relaxant injection Cisatracurium 0.2mg/kg. Group B received 100ml NS 10 mints before general anesthesia (GA) and muscle relaxant injection Cisatracurium 0.2mg/kg. The mean onset of action of injection cis-atracurium after intubating dose in group A was 4. 27+/1.68 minutes as compared to 5.48+/-1 minutes in group B(p-value&amp;#60;0.001) which showed that onset of action was significantly less in group A as compared to group B. Duration of action of intubating dose of cisatracurium was prolonged by pre-treatment of Mgso4. Haemodynamic parameters were comparable and there was no statistically significant difference among both the groups. No side effect reported in our study.

Comparison of C-MAC D-blade videolaryngoscope and McCoy laryngoscope efficacy for nasotracheal intubation in simulated cervical spinal injury: a prospective randomized comparative study

BackgroundImmobilization with cervical spine worsens endotracheal intubation condition. Though various intubation devices have been demonstrated to perform well in oral endotracheal intubation, limited information is available concerning nasotracheal intubation (NTI) in patients with cervical spine immobilization. The present study compared the performance of the C-MAC D-Blade videolaryngoscope with the McCoy laryngoscope for NTI in patients with simulated cervical spine injuries.MethodsThis was a prospective, randomized, controlled, study done in a tertiary hospital. Ninety-five patients requiring NTI were included in data analysis: McCoy group (group M, n = 47) or C-MAC D-Blade videolaryngoscope group (group C, n = 48). A Philadelphia neck collar was applied before anesthetic induction to immobilize the cervical spine. Single experienced anesthesiologist performed NTI. The primary outcome was duration of intubation divided by three steps: nose to oropharynx; oropharynx into glottic inlet; and glottic inlet to trachea. Secondary outcomes included glottic view as percentage of glottis opening (POGO) score and Cormack-Lehance (CL) grade, modified nasal intubation-difficulty scale (NIDS) rating, hemodynamic changes before and after intubation, and complications.ResultsTotal intubation duration was significantly shorter in group C (39.5 ± 11.4 s) compared to group M (48.1 ± 13.9 s). Group C required significantly less time for glottic visualization and endotracheal tube placement in the trachea. More patients in group C had CL grade I and higher POGO scores (P < 0.001, for both measures). No difficulty in NTI (modified NIDS = 0) was more in group C than group M. Hemodynamic changes and incidence of complications were comparable between groups.ConclusionThe C-MAC D-Blade videolaryngoscope is an effective tool for NTI in a simulated difficult airway, which improves glottic visualization and shortens intubation time relative to those with McCoy laryngoscope.Trial registrationClinical Research Information Service of the Korea National Institute of Health, Identification number: KCT 0004535, Registered December 10, 2019, Retrospectively registered, http://cris.nih.go.kr.