McGrath Video Laryngoscopy Facilitates Routine Nasotracheal Intubation in Patients Undergoing Oral and Maxillofacial Surgery: A Comparison With Macintosh Laryngoscopy.
OBJECTIVE
The McGrath video laryngoscope (VL) offers excellent laryngoscopic views and increases the success rate of orotracheal intubation in patients with normal and difficult airways. The purpose of this randomized controlled trial was to compare the McGrath VL with the Macintosh laryngoscope to investigate the efficacy of the McGrath VL for routine nasotracheal intubation in patients with an expected normal airway.


METHODS
To address the research purpose, the efficacy of the McGrath VL for routine nasotracheal intubation was compared with that of the Macintosh laryngoscope. The predictor variable was the laryngoscopic technique (McGrath VL vs Macintosh laryngoscope). The outcome variables were the time to successful intubation, laryngoscopic views before and after optimal external laryngeal manipulation (OELM), use of Magill forceps, ease of intubation, and severity of oropharyngeal bleeding.


RESULTS
Data from 35 patients undergoing oral and maxillofacial surgery were assessed. The time to intubation was 10.5 seconds shorter in the McGrath group than in the Macintosh group (34.4 ± 13.7 vs 44.9 ± 15.6 seconds; P = .004). The incidence of grade 1 glottic view before OELM was higher in the McGrath group than in the Macintosh group (83 vs 57%; P = .019). The frequency of Magill forceps use was lower in the McGrath group than in the Macintosh group (6 vs 34%; P = .003).


CONCLUSIONS
McGrath VL facilitates routine nasotracheal intubation in expected normal airways by providing a shorter intubation time and better laryngoscopic views compared with the Macintosh laryngoscope.
Professor, Department of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon, Korea.
Hyun-Jeong
HJ
Kwak
Clinician, Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea.
Seong-Yeon
SY
Lee
Professor, Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea.
Sook-Young
SY
Lee
Resident, Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea.
Sang-Hyun
SH
Cho
Professor, Department of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon, Korea.
Hong-Soon
HS
Kim
Associate Professor, Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea. Electronic address: kjyeop@ajou.ac.kr.
Jong-Yeop
JY
Kim
D000328:Adult; D062186:Arterial Pressure / Q000502:physiology; D001314:Auscultation / Q000379:methods; D004569:Electroencephalography / Q000379:methods; D005260:Female; D005931:Glottis / Q000033:anatomy & histology; D006339:Heart Rate / Q000502:physiology; D006470:Hemorrhage / Q000175:diagnosis; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D020704:Laryngoscopes / Q000145:classification; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D010100:Oxygen / Q000097:blood; D010608:Pharyngeal Diseases / Q000175:diagnosis; D012135:Respiratory Sounds / Q000175:diagnosis; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult
D010100:Oxygen