title: Muscle activity during endotracheal intubation using 4 laryngoscopes (Macintosh laryngoscope, Intubrite, TruView Evo2 and King Vision) - A comparative study.
abstract: BACKGROUND
  Successful endotracheal intubation requires mental activity and no less important physical activity from the anesthesiologist, so ergonomics of used devices is important. The aim of our study has been to compare 4 laryngoscopes regarding an operator's activity of selected muscles of the upper limb, an operator's satisfaction with used devices and an operator's fatigue during intubation attempts.
  
  
  METHODS
  The study included 13 anesthesiologists of similar seniority. To measure muscle activity MyoPlus 2 with 2-channel surface ElectroMyoGraphy (sEMG) test device was used. Participant's satisfaction with studied devices was evaluated using Visual Analog Scale. An operator's fatigue during intubation efforts was evaluated by means of the modified Borg's scale.
  
  
  RESULTS
  The highest activity of all the studied muscles was observed for the Intubrite laryngoscope, followed by the Mackintosh, TruView Evo2 and the lowest one - for the King Vision video laryngoscope. A significant statistical difference was observed for the King Vision and the rest of laryngoscopes (p < 0.05). No significant statistical differences were observed between the Macintosh, TruView Evo2 and Intubrite laryngoscopes (p > 0.05). The shortest time of intubation was achieved using the standard Macintosh blade laryngoscope. The highest satisfaction was noted for the King Vision video laryngoscope, and the lowest for - the TruView Evo2. The Intubrite was the most demanding in terms of workload, in the opinion of the participants', and the least demanding was the King Vision video laryngoscope.
  
  
  CONCLUSIONS
  Muscle activity, namely the force used for intubation, is the smallest when the King Vision video laryngoscope is used with the highest satisfaction and lowest workload, and the highest muscle activity was proven for the Intubrite laryngoscope with the highest workload. Med Pr 2016;67(2):155-162.
authors.affiliation: Medical University of Lodz / Uniwersytet Medyczny w Łodzi, Łódź, Poland (Department of Emergency Medicine and Disaster Medicine / Zakład Medycyny Ratunkowej i Medycyny Katastrof). tomasz.gaszynski@umed.lodz.pl.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Gaszyński
authors.affiliation: Medical University of Lodz / Uniwersytet Medyczny w Łodzi, Łódź, Poland (Department of Emergency Medicine and Disaster Medicine / Zakład Medycyny Ratunkowej i Medycyny Katastrof). jakubiakj@yahoo.com.
authors.forename: Jakub
authors.initials: J
authors.lastname: Jakubiak
mesh_terms: D000328:Adult; D000072080:Anesthesiologists; D004576:Electromyography; D006804:Ergonomics; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D020704:Laryngoscopes; D008297:Male; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000502:physiology*; D034941:Upper Extremity
keywords: anesthesiology; equipment; intubation; muscle activity; satisfaction; workload