4.5 Article

A comparison of the McGrath® Series 5 videolaryngoscope and Macintosh laryngoscope for double-lumen tracheal tube placement in patients with a good glottic view at direct laryngoscopy

Journal

ANAESTHESIA
Volume 70, Issue 7, Pages 810-817

Publisher

WILEY
DOI: 10.1111/anae.13040

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Funding

  1. National Natural Science Foundation of P.R. China [81000476, 81341034, 30872542, 81171158]
  2. Ministry of Health of P.R. China

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We compared the McGrath((R)) Series 5 videolaryngoscope with the Macintosh laryngoscope for double-lumen tracheal tube placement in patients with a predicted good glottic view on assessment of the airway. An initial laryngoscopy was performed using the Macintosh laryngoscope; 96 patients with Cormack and Lehane grade-1 or -2a views were randomly assigned to undergo intubation using either the McGrath or Macintosh device. Compared with the Macintosh laryngoscope, the McGrath videolaryngoscope provided more Cormack and Lehane grade-1 views (47 (97.9%) vs 29 (60.4%), p<0.05), a longer mean (SD) intubation time (39.6 (10.0)s vs 24.4 (7.3)s, p<0.05) and a higher incidence of double-lumen tube malposition (6 (12.5%) vs 0, p<0.05). However, in 18 non-randomised patients with Cormack and Lehane grade 2b on initial laryngoscopy using the Macintosh, the glottic view was improved on intubation with the McGrath videolaryngoscope, with a total success rate of double-lumen tube placement of 94.4% and mean (SD) intubation time of 50.0 (18.6) s. We recommend that in patients with a low airway risk index score requiring intubation with a double-lumen tracheal tube, the Macintosh laryngoscope is used as the first device and the McGrath videolaryngoscope is used only if this provides a poor glottic view.

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