Impact of pillow height on double-lumen endotracheal tube intubation with McGRATH MAC: a prospective randomized clinical trial.
OBJECTIVE
This study aimed to compare the impact of pillow height on double-lumen tracheal tube (DLT) intubation with McGRATH MAC (McG) in patients undergoing elective surgery.


METHODS
Randomized clinical trial.


METHODS
Operating room.


METHODS
Fifty adult patients scheduled for elective surgery under 1-lung ventilation with an American Society of Anesthesiologists physical status of 1 to 3.


METHODS
DLT intubation with McG was performed with a high pillow (HP group; 25 patients) or low pillow (LP group; 25 patients) by anesthesiologists.


METHODS
Intubation time, number of laryngoscopy, number of tracheal intubation attempts to successful intubation, percentage of glottic opening score, and subjective difficulty of laryngoscopy and tube passage through the glottis were assessed.


RESULTS
Intubation time was significantly shorter in the HP group compared with the LP group (HP: 32.1±14.9seconds vs LP: 49.4±11.2seconds, P<.001). The number of laryngoscopy were 1 (HP group, 22 patients; LP group, 17 patients), 2 (HP group, 3 patient; LP group, 7 patients), and 3 (HP group, 0 patient; LP group, 1 patient), with no significant difference between the 2 groups (P=.197). Although the percentage of glottic opening score did not significantly differ between HP and LP groups (HP: 95.6%±6.7% vs LP: 96.0%±12.3%, P=.08), the number of tracheal intubation attempts was significantly lower in the HP group compared with the LP group (P=.009). The visual analog scale score for laryngoscopy did not significantly differ between the 2 groups (P=.54). However, the visual analog scale for tube passage through the glottis was significantly higher in the LP group than in the HP group (P<.001).


CONCLUSIONS
Intubation with an HP was associated with a better DLT intubation profile than with an LP with McG, possibly due to smoother tracheal tube progression through the glottis.
Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686, Japan.
Shiho
S
Deguchi
Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686, Japan. Electronic address: ane078@osaka-med.ac.jp.
Nobuyasu
N
Komasawa
Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686, Japan.
Haruki
H
Kido
Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686, Japan.
Takeshi
T
Ueno
Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686, Japan.
Toshiaki
T
Minami
D000368:Aged; D000369:Aged, 80 and over; D001512:Bedding and Linens; D017558:Elective Surgical Procedures / Q000379:methods; D004867:Equipment Design; D005260:Female; D005931:Glottis; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061810:One-Lung Ventilation; D011187:Posture; D011446:Prospective Studies
Double-lumen tracheal tube; McGRATH MAC; Pillow height