GlideScope® versus C-MAC®(D) videolaryngoscope versus Macintosh laryngoscope for double lumen endotracheal intubation in patients with predicted normal airways: a randomized, controlled, prospective trial

2020 ◽  
Author(s):  
Ping Huang ◽  
Renlong Zhou ◽  
Zhixing Lu ◽  
Yannan Hang ◽  
Shanjuan Wang ◽  
...  
Keyword(s):  
Endotracheal Intubation ◽  
Rating Scales ◽  
Macintosh Laryngoscope ◽  
Prospective Trial ◽  
Success Rates ◽  
Hemodynamic Changes ◽  
Double Lumen ◽  
Randomized Controlled ◽  
First Choice ◽  
Thoracic Anesthesia

Abstract Background The double lumen endotracheal tube (DLT) is the most widely-used device for single lung ventilation in current thoracic anesthesia practice. In recent years, the routine application of the videolaryngoscope for single lumen endotracheal intubation has increased; nevertheless there are few studies of the use of the videolaryngoscope for DLT. We wondered whether there were benefits to using the videolaryngoscope for DLT placement in patients with predicted normal airways. Therefore, this study was designed to compare the performances of the GlideScope ® , the C-MAC ® (D) videolaryngoscope and the Macintosh laryngoscope in DLT intubation. Methods This was a randomized, controlled, prospective study. We randomly allocated 90 adult patients with predicted normal airways into three groups. All patients underwent routine anesthesia using different laryngoscopes according to group allocation. We compared DLT insertion times, first-pass success rates, numerical rating scales (NRS) of DLT delivery and DLT insertion, Cormack-Lehane degrees (C/L), hemodynamic changes and incidences of intubation complications. All outcomes were analyzed using SPSS13.0. Results Compared with the GlideScope, the Macintosh gave shorter times for DLT insertion (median: 96 (IQR: 51 [min–max: 62–376] s vs 73 (26 [48–419] s, p = 0.003); however, there was no difference between the Macintosh and C-MAC(D) (p = 0.610). The Macintosh had a significantly higher successful first attempt rate than did the GlideScope or C-MAC(D) (p = 0.001, p = 0.028, respectively). NRS of DLT delivery and insertion were significantly lower in the Macintosh than in the others (p <0.001). However, the C/L degree in the Macintosh was significantly higher than in the others (p <0.001). The incidences of oral bleeding, hoarseness, sore throat and dental trauma were low in all groups (p >0.05). There were no significant differences in DLT misplacement, fiberoptic time or hemodynamic changes among the groups. Conclusions Compared with the Macintosh laryngoscope, the GlideScope ® and C-MAC ® (D) videolaryngoscopes may not be recommended as the first choice for routine DLT intubation in patients with predicted normal airways.

scholarly journals GlideScope® versus C-MAC®(D) videolaryngoscope versus Macintosh laryngoscope for double lumen endotracheal intubation in patients with predicted normal airways: a randomized, controlled, prospective trial

2020 ◽  
Author(s):  
Ping Huang ◽  
Renlong Zhou ◽  
Zhixing Lu ◽  
Yannan Hang ◽  
Shanjuan Wang ◽  
...  
Keyword(s):  
Endotracheal Intubation ◽  
Rating Scales ◽  
Macintosh Laryngoscope ◽  
Prospective Trial ◽  
Hemodynamic Changes ◽  
Clinical Trial Registry ◽  
Double Lumen ◽  
Randomized Controlled ◽  
First Choice ◽  
Thoracic Anesthesia

Abstract Background: The double lumen endotracheal tube (DLT) is the most widely-used device for single lung ventilation in current thoracic anesthesia practice. In recent years, the routine application of the videolaryngoscope for single lumen endotracheal intubation has increased; nevertheless there are few studies of the use of the videolaryngoscope for DLT. We wondered whether there were benefits to using the videolaryngoscope for DLT placement in patients with predicted normal airways. Therefore, this study was designed to compare the performances of the GlideScope®, the C-MAC®(D) videolaryngoscope and the Macintosh laryngoscope in DLT intubation.Methods: This was a randomized, controlled, prospective study. We randomly allocated 90 adult patients with predicted normal airways into three groups. All patients underwent routine anesthesia using different laryngoscopes according to group allocation. We compared DLT insertion times, first-pass success rates, numerical rating scales (NRS) of DLT delivery and DLT insertion, Cormack-Lehane degrees (C/L), hemodynamic changes and incidences of intubation complications. All outcomes were analyzed using SPSS13.0. Results: Compared with the GlideScope, the Macintosh gave shorter times for DLT insertion (median: 96 (IQR: 51 [min–max: 62–376] s vs 73 (26 [48–419] s, p = 0.003); however, there was no difference between the Macintosh and C-MAC(D) (p = 0.610). The Macintosh had a significantly higher successful first attempt rate than did the GlideScope or C-MAC(D) (p = 0.001, p = 0.028, respectively). NRS of DLT delivery and insertion were significantly lower in the Macintosh than in the others (p <0.001). However, the C/L degree in the Macintosh was significantly higher than in the others (p <0.001). The incidences of oral bleeding, hoarseness, sore throat and dental trauma were low in all groups (p >0.05). There were no significant differences in DLT misplacement, fiberoptic time or hemodynamic changes among the groups.Conclusions: Compared with the Macintosh laryngoscope, the GlideScope® and C-MAC®(D) videolaryngoscopes may not be recommended as the first choice for routine DLT intubation in patients with predicted normal airways.Trial registration :The study was prospectively registered at the Chinese Clinical Trial Registry (no. ChiCTR1900025718); principal investigator: Z.L.H.; date of registration: September 6, 2019.

scholarly journals A randommized, prospective, controlled trial of Glidscope®, C-MAC®(D) videolaryngoscope and Macintosh laryngoscope for double lumen endotracheal intubation in patients with predicted normal airways

2020 ◽  
Author(s):  
Ping Huang ◽  
Renlong Zhou ◽  
Zhixing Lu ◽  
Yannan Hang ◽  
Shanjuan Wang ◽  
...  
Keyword(s):  
Rating Scale ◽  
Clinical Performance ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Macintosh Laryngoscope ◽  
Dental Trauma ◽  
Tube Placement ◽  
Double Lumen ◽  
First Choice ◽  
Thoracic Anesthesia

Abstract Background Double lumen endotracheal tube (DLT) is the most widely used method for lung isolation in current thoracic anesthesia practice. In recent years, the routine application of videolaryngoscope for tracheal intubation has gradually increased, but there are still few related reports. We doubted whether we could get benefits from applying the videolaryngoscope for double-lumen tracheal tube placement in patients with predicted normal airways. Therefore, this study was designed to compare the clinical performance of GlideScope ® , C-MAC ® (D) videolaryngoscope and Macintosh laryngoscope in DLT intubation. Methods 90 adult patients with no predictors for difficult airways were allocated randomly into three groups. All the patients were anesthsized by a routine anesthesia process with different laryngoscopes according to the result of allocation. We accessed DLT insertion time, first-pass success rate, numerical rating scale (NRS) of DLT delivery, NRS of DLT insertion and Cormack-Lehane degree(C/L degree). The hemodynamic change and the incidence of intubation complications were also recorded. Results Compared with GlideScope, Macintosh resulted in shorter time for DLT insertion (median:96(IQR:51[min-max:62–376]s v 73(26[48-419]s, p=0.003), but there was no difference between Macintosh and C-MAC(D) (p=0.610). As for the success at the first attempt, Macintosh was significantly associated with higher successful rate compared with GlideScope and C-MAC(D) (p=0.001, p=0.028, respectively). NRS of DLT delivery and NRS of DLT insertion were significantly lower in Macintosh group than others (p<0.001, respectively). However, C/L degree (I/II A /II B /III) in Macintosh group was statistically higher than others (p<0.001, respectively). The incidence of oral bleeding, hoarseness, sore throat and dental trauma were low in all groups (p>0.05, respectively). There were no statistical difference about DLT misplacement, fibreoptic time and hemodynamic changes among three groups. Conclusions GlideScope ® and C-MAC ® (D) videolaryngoscopes may not be recommended as the first choice for routine DLT intubation in patients with predicted normal airways.

scholarly journals Tracheal intubation skill retention using a McGRATH® MAC video laryngoscope with real-time feedback by faculty in novice first-year residents: A randomized controlled trial

2021 ◽  
Author(s):  
Yu Yamamoto ◽  
Shohei Kimura ◽  
Hideki Kuniyoshi ◽  
Takanori Hiroe ◽  
Takako Terui ◽  
...  
Keyword(s):  
Endotracheal Intubation ◽  
Controlled Trial ◽  
Macintosh Laryngoscope ◽  
Video Laryngoscope ◽  
Controlled Study ◽  
First Year ◽  
Video Monitor ◽  
Randomized Controlled ◽  
Mcgrath Mac ◽  
Time Required

Abstract BackgroundDuring endotracheal intubation training, only providing verbal guidance to students may result in inadequate recognition of the inner larynx and cause delays in mastering endotracheal intubation. Therefore, we introduced a deliberate practice approach to the education of residents in endotracheal intubation. For this purpose, a video laryngoscope was used to give the residents detailed feedback of the anesthesiology faculty. We hypothesized that if the anesthesiology faculty could provide sufficient and precise feedback of the larynx through the video monitor, the residents’ intubation skills would be retained for a more extended period.MethodsThis cluster randomized controlled study enrolled first-year residents who completed a two-month rotation at our department. Each rotation group (2–4 residents) was assigned to the Macintosh laryngoscope (ML) group or the McGRATH MAC video laryngoscope (MML) group. Endotracheal intubation skills were evaluated on a simulated mannequin immediately after the rotation, three months later, and six months later. The primary endpoint was the time required for intubation. The secondary endpoint was the percentage of glottic opening (POGO) score.ResultsForty-six residents participated in this study and were assigned to the ML group (n = 23) or the MML group (n = 23). The time required for intubation was significantly shorter in the MML group than in the ML group. The POGO score did not show any significant differences between the two groups; however, the POGO score of the MML group had a relatively narrower confidence interval than the ML group.ConclusionsWhen comparing endotracheal intubation training using the Macintosh laryngoscope and video laryngoscope, the McGRATH MAC video laryngoscope shortened the intubation procedure and facilitated long-term skill retention.Trial registrationClinical registry and trial number, URL: https://www.umin.ac.jp, UMIN000036643 date of registration: 2019/05/03, This study was retrospectively registered.

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