title: Comparison of the laryngoscopy views with the size 1 Miller and Macintosh laryngoscope blades lifting the epiglottis or the base of the tongue in infants and children <2 yr of age.
abstract: BACKGROUND
  Miller laryngoscope blades are preferred for laryngoscopy in infants and children <2 yr of age. Despite their long history, the laryngeal view with the Miller blade size 1 has never been compared with that with the Macintosh (MAC) blade in children. This prospective, single-blinded, randomized study was designed to compare the laryngeal views with the size 1 Miller and MAC blades in children <2 yr.
  
  
  METHODS
  With IRB approval, 50 ASA I and II children <2 yr undergoing elective surgery were enrolled. After an inhalation induction and neuromuscular block with i.v. rocuronium 0.5 mg kg(-1), two laryngeal views were obtained with a single blade (Miller or MAC) in each child: one lifting the epiglottis and another lifting the tongue base. The best laryngeal views in each blade position were photographed with a SONY(®) Cyber-shot camera and rated by a blinded anaesthesiologist using the percentage of glottic opening scale.
  
  
  RESULTS
  The scores with the Miller blade lifting the epiglottis and the MAC blade lifting the tongue base were similar. The scores with the Miller blade lifting the epiglottis and the tongue base were similar. The scores for the MAC blade lifting the tongue base were greater than those lifting the epiglottis (95% confidence interval: 7.6-26.8) (P=0.0004).
  
  
  CONCLUSIONS
  In infants and children <2 yr of age, optimal laryngeal views may be obtained with either the Miller size 1 blade lifting the epiglottis or with the Miller or MAC blades lifting the tongue base.
  
  
  BACKGROUND
  NCT01717872 at Clinical Trials.gov.
authors: Department of Anesthesia, Women and Children's Hospital of Buffalo, SUNY at Buffalo, 219 Bryant St., Buffalo, NY 14222, USA.
authors: Y
authors: Y
authors: Passi
authors: Department of Anesthesia, Women and Children's Hospital of Buffalo, SUNY at Buffalo, 219 Bryant St., Buffalo, NY 14222, USA.
authors: M
authors: M
authors: Sathyamoorthy
authors: Department of Anesthesia, Women and Children's Hospital of Buffalo, SUNY at Buffalo, 219 Bryant St., Buffalo, NY 14222, USA University of Rochester, Rochester, NY, USA jerrold.lerman@gmail.com.
authors: J
authors: J
authors: Lerman
authors: Department of Anesthesia, Women and Children's Hospital of Buffalo, SUNY at Buffalo, 219 Bryant St., Buffalo, NY 14222, USA Department of Pediatrics and Pediatric Dentistry, Women and Children's Hospital of Buffalo, SUNY at Buffalo, 219 Bryant St., Buffalo, NY 14222, USA.
authors: C
authors: C
authors: Heard
authors: Department of Anesthesia, Women and Children's Hospital of Buffalo, SUNY at Buffalo, 219 Bryant St., Buffalo, NY 14222, USA.
authors: M
authors: M
authors: Marino
mesh_terms: D000769:Anesthesia, Inhalation; D004825:Epiglottis / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D007830:Larynx / Q000033:anatomy & histology; D008297:Male; D019148:Neuromuscular Blockade; D011446:Prospective Studies; D014059:Tongue / Q000033:anatomy & histology*
keywords: age groups; child, infant; equipment, laryngoscopes; larynx, laryngoscopy