1887
Volume 2025, Issue 3
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

The study aimed to assess and compare the ease and success of intubation using channeled (Airtraq [AT]) versus non-channeled (McGrath [MG]) videolaryngoscopes in a simulated difficult airway.

This prospective, randomized, single blind study was conducted on 50 patients of either sex, aged between 20 and 60 years, belonging to American Society of Anesthesiologists I–II physical status, undergoing a surgical procedure requiring intubation. The appropriate size Philadelphia rigid cervical collar was applied to all patients. After the induction of anesthesia, patients were randomly allocated to one of two groups comprising 25 patients, using sealed envelopes. Group AT ( = 25) were intubated using Airtraq laryngoscope and group MG ( = 25) were intubated with McGrath laryngoscope. In all the patient’s successful intubation times, the first attempt success rate, Percentage of Glottic Opening (POGO), and Intubation Difficulty Scale score were noted. Hemodynamic changes were recorded immediately after intubation thereafter at 1, 3, and 5 minutes after successful intubation. Any kind of Airway trauma and postoperative sore throat was taken into note.

Mean age in group AT was 39.68 ± 20.13 years compared to 37.56 ± 10.20 years in group MG. Intubation time was recorded and was found to be 87.28 ± 28.85 seconds with Airtraq and 65.60 ± 29.48 seconds with McGrath ( = 0.011). The POGO score was better in group AT than in group MG. The first attempt success rate was 84.0% in group AT compared to 76.0% in group MG ( = 0.725).

Though the channeled laryngoscope offers superior intubating conditions, enhanced ease, and an improved glottic view compared to the McGrath laryngoscope.

Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2025.29
2025-09-15
2025-12-05

Metrics

Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2025/3/jemtac.2025.29.html?itemId=/content/journals/10.5339/jemtac.2025.29&mimeType=html&fmt=ahah

References

  1. Ju Hong H, Yun M, Hoon Kim S, Jung Won Hwang J, Chul Lee H. A pillow of 8 cm height did not improve laryngeal view and alignment of airway axes but increased anesthesiologist discomfort compared to a pillow of 4 cm height during tracheal intubation in adult patients. Korean J Anesthesiol. 2016 Mar; 69:(2):138–42.http://doi.org/10.4097/kjae.2016.69.2.138
    [Google Scholar]
  2. Dhar M, Karim HM, Rajaram N, Prakash A, Sahoo SK, Narayan A. A randomised comparative study on customised versus fixed sized pillow for tracheal intubation in the sniffing position by Macintosh laryngoscopy. Indian J Anaesth. 2018 May; 62:(5):344–9.http://doi.org/10.4103/ija.IJA_672_17
    [Google Scholar]
  3. Holla M, Huisman JMR, Verdonschot N, Goosen J, Hosman AJE, Hannink G. The ability of external immobilizers to restrict movement of the cervical spine: a systematic review. Eur Spine J. 2016 Jul; 25:(7):2023–36.http://doi.org/10.1007/s00586-016-4379-6
    [Google Scholar]
  4. Majernick TG, Bieniek R, Houston JB, Hughes HG. Cervical spine movement during orotracheal intubation. Ann Emerg Med. 1986 Apr; 15:(4):417–20.http://doi.org/10.1016/s0196-0644(86)80178-0
    [Google Scholar]
  5. Watts ADJ, Gelb AW, Bach DB, Pelz DM. Comparison of the Bullard and Macintosh laryngoscopes for endotracheal intubation of patients with a potential cervical spine injury. Anesthesiology. 1997 Dec; 87:(6):1335–42.http://doi.org/10.1097/00000542-199712000-00012
    [Google Scholar]
  6. Hastings RH, Vigil AC, Hanna R, Yang BY, Sartoris DJ. Cervical spine movement during laryngoscopy with the Bullard, Macintosh, and Miller laryngoscopes. Anesthesiology. 1995 Apr; 82:(4):859–69.http://doi.org/10.1097/00000542-199504000-00007
    [Google Scholar]
  7. Maruyama K, Yamada T, Kawakami R, Hara K. Randomized cross-over comparison of cervical-spine motion with the Airway Scope or Macintosh laryngoscope with in-line stabilization: a video-fluoroscopic study. Br J Anaesth. 2008 Oct: 101:(4):563–67. http://doi.org/10.1093/bja/aen207
    [Google Scholar]
  8. Ford PN, Hamer C, Medakkar S. Use of the Airtraq in the difficult airway. Eur J Anaesthesiol. 2007 Aug; 24:(8):730–31.http://doi.org/10.1017/s0265021507000233
    [Google Scholar]
  9. Cavus E, Dorges V. Video laryngoscopes. In: Hagberg CA (ed.), Benumof and Hagberg’s Airway Management (3rd ed.). Philadelphia: Elsevier Saunders; 2016. p.542.
    [Google Scholar]
  10. Karalapillai D, Darvall J, Mandeville J, Ellard L, Graham J, Weinberg L. A review of video laryngoscopes relevant to the intensive care unit. Indian J Crit Care Med. 2014 Jul; 18:(7):442–52.http://doi.org/10.4103/0972-5229.136073
    [Google Scholar]
  11. Schmitt HJ, Mang H. Head and neck elevation beyond the sniffing position improves laryngeal view in cases of difficult direct laryngoscopy. J Clin Anesth. 2002 Aug; 14:(5):335–8.http://doi.org/10.1016/s0952-8180(02)00368-9
    [Google Scholar]
  12. Adnet F, Borron SW, Racine SX, Clemessy JL, Fournier JL, Plaisance P, Lapandry C. The intubation difficulty scale (IDS): proposal and evaluation of a new score characterizing the complexity of endotracheal intubation. Anesthesiology. 1997 Dec; 87:(6):1290–7.http://doi.org/10.1097/00000542-199712000-00005
    [Google Scholar]
  13. Wan L, Liao M, Qian W, Hu R, Chen K, Zhang C, et al. McGrath Series 5 videolaryngoscope vs Airtraq DL videolaryngoscope for double-lumen tube intubation.Medicine (Baltimore). 2016 Dec; 95:(51):e5739.http://doi.org/10.1097/MD.0000000000005739
    [Google Scholar]
  14. Kleine-Brueggeney M, Greif R, Schoettker P, Savoldelli GL, Nabecker S, Theiler LG. Evaluation of six videolaryngoscopes in 720 patients with a simulated difficult airway: a multicentre randomized controlled trial. Br J Anaesth. 2016 May; 116:(5):670–9.http://doi.org/10.1093/bja/aew058
    [Google Scholar]
  15. Raza N, Hasan M, Ahmed SM, Bano S, Athar M. A comparative study of McGrath and Airtraq videolaryngoscopes for tracheal intubation. J Anaesthesiol Clin Pharmacol. 2017 Apr-Jun; 33:(2):221–25.
    [Google Scholar]
  16. Gómez-Ríos MA, Pinegger S, Mantilla M, Vizcaino L, Barreto-Calvo P, Paech MJ, et al A randomised crossover trial comparing the Airtraq® NT, McGrath® MAC and Macintosh laryngoscopes for nasotracheal intubation of simulated easy and difficult airways in a manikin. Rev Bras Anestesiol. 2016 May-Jun; 66:(3):289–97.http://doi.org/10.1016/j.bjan.2016.02.014
    [Google Scholar]
  17. Owada G, Mihara T, Inagawa G, Asakura A, Goto T, Ka K. A comparison of the Airtraq®, McGrath®, and Macintosh laryngoscopes for difficult paediatric intubation: A manikin study. PLoS One. 2017 Feb; 12:(2):e0171889.http://doi.org/10.1371/journal.pone.0171889
    [Google Scholar]
/content/journals/10.5339/jemtac.2025.29
Loading
/content/journals/10.5339/jemtac.2025.29
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error