Comparing Shikani Optical Stylet and Macintosh Laryngoscope for Orotracheal Intubation

Background: Laryngoscopy and intubation cause activation of the sympathetic nervous system and can results in tachycardia, arrhythmias and hypertension. Hypertensive patients demonstrate a relatively greater rise in catecholamine secretion and an increased sensitivity to them. Aim of the study is to compare the haemodynamic stress response associated with orotracheal intubation using videolaryngoscope or Macintosh laryngoscope in controlled hypertensive patients. Methods: Sixty hypertensive, American Society of Anesthesiologist’s class II, patients were randomly divided in to two groups. In group V (videolaryngoscope), intubation was done with i-scope videolaryngoscope. In group M (Macintosh), intubation was done using Macintosh laryngoscope. Primary objectives of the study pulse rate (PR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) were noted immediately after and at 1, 2, 3, 5 and 10 minutes after intubation. Results: The demographic data were comparable in both groups. There was no significant difference at baseline for mean (SD) PR, SBP, DBP and MBP at baseline and after induction/before intubation (p>0.05). The mean (SD) PR, SBP, DBP and MBP were significantly higher in Macintosh laryngoscope group as compared to i-scope videolaryngoscope immediately after intubation, 1, 2, 3, 5 and 10 minutes after intubation (p<0.001). Conclusion: We found that intubation with the use of i-scope videolaryngoscope results in less haemodynamic stress response than Macintosh laryngoscope in controlled hypertensive patients.

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Comparison of four channelled videolaryngoscopes to Macintosh laryngoscope for simulated intubation of critically ill patients: the randomized MACMAN2 trial

Annals of Intensive Care ◽

10.1186/s13613-021-00916-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Paul Decamps ◽

Nicolas Grillot ◽

Aurelie Le Thuaut ◽

Noelle Brule ◽

Corinne Lejus-Bourdeau ◽

...

Keyword(s):

Success Rate ◽

Critically Ill ◽

Critically Ill Patients ◽

Macintosh Laryngoscope ◽

Lower Boundary ◽

Random Order ◽

Orotracheal Intubation ◽

Success Rates ◽

First Pass ◽

Macintosh Laryngoscopy

Abstract Background Videolaryngoscopes with an operating channel may improve the intubation success rate in critically ill patients. We aimed to compare four channelled videolaryngoscopes to the Macintosh laryngoscope used for intubation of a high-fidelity simulation mannikin, in a scenario that simulated critical illness due to acute respiratory failure. Results Of the 79 residents who participated, 54 were considered inexperienced with orotracheal intubation. Each participant used all five devices in random order. The first-pass success rate was 97.5% [95% CI 91.1–99.7] for Airtraq™, KingVision™, and Pentax AWS200™, 92.4% [95% CI 84.2–97.2] for VividTrac VT-A100™, and 70.9% [95% CI 59.6–80.6] for direct Macintosh laryngoscopy. The first-pass success rate was significantly lower with direct Macintosh laryngoscopy than with the videolaryngoscopes (p < 0.0001 for Airtraq™, KingVision™, Pentax AWS200™, and VividTrac VT-A100™). Conclusion The Airtraq™, KingVision™, and Pentax AWS200™ channelled videolaryngoscopes produced high first-pass success rates with a lower boundary of the 95% CI above 90%. A multicentre, randomised controlled clinical study comparing channelled videolaryngoscopy to direct laryngoscopy should include one of these three videolaryngoscopes.

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Faculty Opinions recommendation of McGRATH MAC videolaryngoscope versus Macintosh laryngoscope for orotracheal intubation in intensive care patients: the randomised multicentre MACMAN trial study protocol.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726038012.793528512 ◽

2017 ◽

Author(s):

Michael Aziz

Keyword(s):

Intensive Care ◽

Study Protocol ◽

Macintosh Laryngoscope ◽

Orotracheal Intubation ◽

Intensive Care Patients ◽

Mcgrath Mac

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Reply to “Comparing Shikani Optical Stylet and Macintosh Laryngoscope for Orotracheal Intubation”

Chinese Medical Journal ◽

10.4103/0366-6999.208266 ◽

2017 ◽

Vol 130 (13) ◽

pp. 1630 ◽

Cited By ~ 1

Author(s):

Mao Xu ◽

Xiao-Xi Li ◽

Xiang-Yang Guo ◽

Jun Wang

Keyword(s):

Macintosh Laryngoscope ◽

Orotracheal Intubation

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Craniocervical Motion during Direct Laryngoscopy and Orotracheal Intubation with the Macintosh and Miller Blades

Anesthesiology ◽

10.1097/01.anes.0000291461.62404.46 ◽

2007 ◽

Vol 107 (6) ◽

pp. 884-891 ◽

Cited By ~ 24

Author(s):

Scott A. LeGrand ◽

Bradley J. Hindman ◽

Franklin Dexter ◽

Julie B. Weeks ◽

Michael M. Todd

Keyword(s):

Direct Laryngoscopy ◽

Sagittal Plane ◽

Macintosh Laryngoscope ◽

Cervical Vertebra ◽

Random Order ◽

Orotracheal Intubation ◽

Mean Difference ◽

Routine Practice ◽

Macintosh Blade ◽

Cervical Motion

Background Previous studies have characterized segmental craniocervical motion that occurs during direct laryngoscopy and intubation with a Macintosh laryngoscope blade. Comparable studies with the Miller blade have not been performed. The aim of this study was to compare maximal segmental craniocervical motion occurring during direct laryngoscopy and orotracheal intubation with Macintosh and Miller blades. Methods Eleven anesthetized and pharmacologically paralyzed patients underwent two sequential orotracheal intubations, one with a Macintosh blade and another with a Miller in random order. During each intubation, segmental craniocervical motion from the occiput to the fifth cervical vertebra (C5) was recorded using continuous lateral cinefluoroscopy. Single-frame images corresponding to the point of maximal cervical motion for both blade types were compared with a preintubation image. Using image analysis software, angular change in the sagittal plane at each of five intervertebral segments was compared between the Macintosh and Miller blades. Results Extension at occiput-C1 was greater with the Macintosh blade compared with the Miller (12.1 degrees +/- 4.9 degrees vs. 9.5 degrees +/- 3.8 degrees, respectively; mean difference = 2.7 degrees +/- 3.0 degrees; P = 0.012). Total craniocervical extension (occiput-C5) was also greater with the Macintosh blade compared with the Miller (28.1 degrees +/- 9.5 degrees vs. 23.2 degrees +/- 8.4 degrees, respectively; mean difference = 4.8 degrees +/- 4.4 degrees; P = 0.008). Conclusions Compared with the Macintosh, the Miller blade was associated with a statistically significant, but quantitatively small, decrease in cervical extension. This difference is likely too small to be important in routine practice.

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Comparison of McGrath Videolaryngoscope and Macintosh Laryngoscope in Children with Torticollis: Randomized Controlled Trial

Children ◽

10.3390/children8121171 ◽

2021 ◽

Vol 8 (12) ◽

pp. 1171

Author(s):

Min Hur ◽

Jong Yeop Kim ◽

Sang Kee Min ◽

Kyuheok Lee ◽

Young Ju Won ◽

...

Keyword(s):

Success Rate ◽

Controlled Trial ◽

Macintosh Laryngoscope ◽

Orotracheal Intubation ◽

Difficulty Level ◽

Intubation Time ◽

Intubation Difficulty ◽

Lifting Force ◽

Lehane Grade ◽

Difficulty Scale

We investigated the efficacy of the McGrath videolaryngoscope compared with the Macintosh laryngoscope in children with torticollis. Thirty children aged 1–10 years who underwent surgical release of torticollis were randomly assigned into the McGrath and Macintosh groups. Orotracheal intubation was performed by a skilled anesthesiologist. The primary outcome was the intubation time. The Cormack–Lehane grade, lifting force, intubation difficulty scale (IDS), difficulty level, and intubation failure rate were also assessed. The intubation time was significantly longer in the McGrath group than in the Macintosh group (31.4 ± 6.7 s vs. 26.1 ± 5.4 s, p = 0.025). Additionally, the Cormack–Lehane grades were comparable between the groups (p = 0.101). The lifting force and IDS were significantly lower in the McGrath group than in the Macintosh group (p < 0.001 and p = 0.022, respectively). No significant differences were observed with respect to endotracheal intubation difficulty and intubation success rate. Intubation-related complications were also not observed. In conclusion, compared with the Macintosh laryngoscope, the McGrath videolaryngoscope extended the intubation time and did not improve glottic visualization in children with torticollis, despite having a lesser lifting force, lower intubation difficulty scale, and similar success rate.

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CARDIOVASCULAR RESPONSE TO LARYNGOSCOPY VERSUS FIBER-OPTIC BRONCHOSCOPE DURING OROTRACHEAL INTUBATION IN PATIENTS UNDERGOING ELECTIVE SURGERY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-1.2544 ◽

2021 ◽

Vol 71 (Suppl-1) ◽

pp. S180-85

Author(s):

Moazzam Ali ◽

Maliha Khawar ◽

Maryam Nazneen ◽

Zaqawat Nazneen

Keyword(s):

Heart Rate ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Fiber Optic ◽

Cardiovascular Response ◽

Macintosh Laryngoscope ◽

Orotracheal Intubation ◽

Control Group ◽

Female Ratio ◽

The Mean

Objective: To compare the hemodynamic response between flexible fiber optic bronchoscope (FOB) andMacintosh laryngoscope during orotracheal intubation. The secondary objective was to calculate the timerequired for intubation between these two techniques Study Design: Quasi experimental study. Place and Duration of Study: Department of Anesthesia, Frontier Corps Hospital Quetta, from Oct 2016 to Apr2017. Methodology: Eighty patients fulfilling the inclusion/exclusion criteria were included in this study and weredivided randomly into two groups. Group L was intubated with Macintosh laryngoscope (control group) whereas group F was intubated with Fiber optic bronchoscope. Mean arterial pressure and heart rate was recorded as baseline, pre-intubation and then every 01 minute for 03 minutes. Changes in heart rate and mean arterial pressure were recorded in the proforma by another anesthetist who was blinded to the procedure performed. Results: The mean age in group L was 41.23 ± 8.37 years and in group F was 40.73 ± 9.77 years. The mean weight in group L was 69.63 ± 8.92 kg and in group F was 70.6 ± 9.20 kg. In group L, male to female ratio was 26:14 whereas in group F it was 28:12. Mean heart rate and mean arterial pressure did not show significant change over time between groups. Time required for intubation was significantly less (22.45 ± 4.12 secs) in laryngoscopy group versus Fiber-Optic Bronchoscope group (44.68 ± 5.88 secs). Conclusion: In conclusion we can say that our study demonstrated that using laryngoscope or Fiber-OpticBronchoscope for orotracheal..........

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