title: Truview EVO2 Laryngoscope Reduces Intubation Difficulty in Maxillofacial Surgeries.
abstract: OBJECTIVE
  Recently, there has been a dramatic increase in the use of the Truview EVO2 for the management of patients with potentially difficult airways. However, the comparison of Truview EVO2 with the classic Macintosh laryngoscope in patients with maxillofacial trauma remains unevaluated. Thus, the purpose of this study was to evaluate and compare the intubation conditions with the Truview EVO2 video laryngoscope and the Macintosh laryngoscope in patients with maxillofacial injury.
  
  
  METHODS
  Forty-two patients with American Society of Anesthesiologists status I and II requiring nasotracheal intubation for maxillofacial surgery were included in this prospective randomized trial. Anesthesia was induced with fentanyl 2 μg/kg, propofol 2 to 3 mg/kg, and rocuronium bromide 0.6 mg/kg. Intubation was performed with the Macintosh laryngoscope or the Truview EVO2 video laryngoscope. Comparative data based on the Intubation Difficulty Scale score were assessed as the primary outcome. Laryngoscopic view, time taken for glottis visualization, time taken to pass the endotracheal tube, total time to intubate, and the number of optimizing and hemodynamic variables were recorded as secondary outcomes.
  
  
  RESULTS
  The 2 groups were comparable in patient characteristics and preoperative airway assessment parameters. The Intubation Difficulty Scale score was significantly less in the Truview EVO2 group compared with the Macintosh group (mean ± standard deviation, 0.30 ± 0.7 vs 1.70 ± 1.8; P = .002). The Truview EVO2 video laryngoscope required significantly less time for glottic visualization (9.40 ± 10.9; P = .002). The Truview EVO2 provided a significantly better laryngoscopic view as graded by the percentage of glottic opening and the modified Cormack-Lehane grading system compared with the Macintosh laryngoscope (P < .002). The hemodynamic variables, number of optimizing maneuvers, and the incidence of side-effects were comparable in the 2 groups.
  
  
  CONCLUSIONS
  The Truview EVO2 performs better than the Macintosh laryngoscope because it considerably decreases the intubation difficulty in patients undergoing maxillofacial surgeries. Therefore, the Truview EVO2 could be a good alternative for managing a difficult airway in patients with maxillofacial injury.
authors.affiliation: Resident, Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Shubhakalyan
authors.initials: S
authors.lastname: Shrestha
authors.affiliation: Additional Professor, Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Arora
authors.affiliation: Assistant Professor, Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: jaindivya77@rediffmail.com.
authors.forename: Divya
authors.initials: D
authors.lastname: Jain
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Vidya
authors.initials: V
authors.lastname: Rattan
authors.affiliation: Professor and Department Head, Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Rakesh Kumar
authors.initials: RK
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D020704:Laryngoscopes; D008297:Male; D011446:Prospective Studies; D013515:Surgery, Oral; D055815:Young Adult