Comparison of Laryngeal Visualisation and Ease of Intubation Between Macintosh and Medan Video Laryngoscope (original) (raw)
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EJCMM, 2023
Background: The essence of anaesthesia practice in every case is uneventful laryngoscopy and intubation. The current study compared the King Vision Video Laryngoscope (KVVL) channelled blade to the Macintosh laryngoscope (ML) in terms of laryngoscopic view, laryngoscopic time, and time required to complete tracheal intubation with the head in neutral position. We aimed to see if there were any drawbacks to using the King Vision Video Laryngoscope in routine clinical practice in terms of hemodynamics. Methods: Eighty patients undergoing elective surgery requiring general anaesthesia and tracheal intubation were randomly assigned to receive either the King Vision Video Laryngoscope or the Macintosh laryngoscope for tracheal intubation. Data were collected during and after laryngoscopy and endotracheal intubation which included laryngoscopic view, time and side effects after a standardised general anaesthetic. Results: The average tracheal intubation time (TTI) for the King Vision Video Laryngoscope and the Macintosh laryngoscope were 24.9 and 26.5 seconds, respectively (p =0.596). The mean duration of laryngoscopy (DOL) for the King Vision Video Laryngoscope and the Macintosh laryngoscope was 46.5 and 46.4 seconds, respectively (p = 0.925). Only 37.5% of the ML group had a Cormack Lehane grade 1 glottic view, whereas all of the KVVL group had a grade 1 glottic view. For KVVL and ML, the percentages of patients who did not require optimisation manoeuvres were 72.5% and 27.5%, respectively. Both groups experienced comparable changes in hemodynamic profile. Conclusion: The King Vision Video Laryngoscope has comparable efficacy in terms of intubation time, laryngoscopy duration, success rate, and ease of intubation. Although King Vision provided a higher percentage of the best laryngoscopic view with fewer optimization manoeuvres eventhough without statistical significance, it provides no additional benefit in European Journal of Molecular & Clinical Medicine ISSN 2515-8260 Volume 09, Issue 07, 2022 9648 terms of hemodynamic response to intubation. The need for a sniffing position is not needed in KVVL group. As a result, we conclude that the King Vision Video Laryngoscope can be used for tracheal intubation in routine clinical practice.
Background and Aims: Securing the airway with an endotracheal tube is considered the standard of care for surgeries requiring general anaesthesia. The Macintosh laryngoscope is the most commonly used device for directly visualising the structures of the larynx and facilitating tracheal intubation. Video laryngoscopes (VLS) which work on the principles of indirect laryngoscopy is found to improve the visualisation of larynx and increase success rate with laryngoscopy and intubation in manikin studies and difficult airway scenarios. Its usefulness in routine intubations in operative settings is yet to be evaluated. Material and Methods: After institutional ethical committee approval and patient consent, eighty ASA I/II patients, aged 18 to 60 years, with normal airway, who underwent elective surgeries under general anaesthesia were included in the study. Patients were randomly allocated into two groups of 40 each, to undergo laryngoscopy and oro-tracheal intubation using either Macintosh direct laryngoscope (group D) or C MAC ® video Laryngoscope (Group V) following induction of general anaesthesia. Cormack Lehane laryngoscopy grading, number of attempts required for intubation, need for stylet, backwards upwards rightwards pressure (BURP) manoeuvre, duration of intubation, haemodynamics during laryngoscopy and intubation, and overall ease of intubation were compared. Results: Duration of intubation was more in group V in contrast to group D which was statistically significant (29.5±19.12 s Vs 12.22±9.25 s). There was also a significant increase in the usage of stylet in group V in comparison to group D (12 Vs 1). Combined usage of both BURP and Stylet was required in 8 patients of group V in contrast to one patient in group D. Conclusion: C-MAC ® Video laryngoscope though improved the Cormack and Lehane grading, its use is associated with longer time for intubation, higher combined use of stylet and BURP manoeuvres to negotiate the endotracheal tube through the vocal cords in comparison with Macintosh laryngoscope in adult patients with normal airway.
Texila International Journal of Public Health, 2024
Intubation is a crucial medical procedure that involves the insertion of a tube into the airway to ensure proper breathing and save lives. This technique, which is fundamental in the field of anaesthesia, requires skill and precision. Anaesthesiologists play a key role in mastering, teaching, and performing intubations, making it a cornerstone of their practice for many years. Traditionally, machine learning has been utilized as a reliable method for tracheal cannulation, establishing itself as the gold standard over the past seven decades. In recent times, there has been a notable development in intubation technology with the introduction of alternative devices such as the King Vision Video Laryngoscope (KVVL). Unlike the conventional method that relies on direct visualization, the KVVL utilizes an indirect magnified image for enhanced accuracy during the procedure. A comparative study was conducted between the King Vision Video Laryngoscope and the traditional Macintosh Laryngoscope on two groups of patients, with Group A consisting of 70% male and 30% female, and Group B with 60% male and 40% female participants. The results of the study revealed that while BMI, thyromental distance, and MPC showed no significant differences between the two devices, the King Vision Video Laryngoscope outperformed the Macintosh Laryngoscope in terms of intubation difficulty score and Cormack Lehane grading. Moreover, the former demonstrated superior outcomes in terms of airway trauma, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and saturation levels, ensuring a smoother and safer intubation process overall. Based on these findings, the study concluded that the King Vision Video Laryngoscope offers distinct advantages over the traditional Macintosh Laryngoscope, highlighting its potential as a superior tool for efficient and effective airway management in clinical settings.
Open Access Macedonian Journal of Medical Sciences, 2021
BACKGROUND: Management of the airway in patients undergoing surgery is increasingly difficult. The airway management in the operating room in terms of the initial action of anesthesia is very important. Video-laryngoscopy has been shown to provide a better view of the larynx’s structure compared to direct visualization. AIM: We describe our experience using a custom made and inexpensive tool for a video-laryngoscopy. METHODS: This is an experimental research with single randomized clinical trial conducted at the Anesthesiology Department of Sanglah General Hospital Denpasar. There were 270 patients divides into three group with conventional, O-Mac® and Mc-GRATH™ BF laryngoscope, aged 18–65 years old, with Mallampati grade 1–2, randomly selected, and signed informed consent. RESULTS: Intubation time fastest with O-Mac® median 26 (15–36) s, p = 0.000. Laryngoscopy time fastest with O-Mac® median 5.5 (2–13 s), p = 0.000. O-Mac® does not use many tools, p = 0.000. All three did not prod...
The American Journal of Emergency Medicine, 2013
Objectives: Tracheal intubation is used to maintain a patent airway and can occasionally be difficult in a potentially difficult airway, especially for novice managers. In this study, we evaluated the time required, extent of the difficulty, and number of dental clicks in the tracheal intubation for novice medical students between the Macintosh (Truphatek International Ltd, Netanya, Israel) and 3 video laryngoscopes in normal and difficult simulated intubation positions on manikins on both the table and floor. Methods: We recruited 20 medical students as novice airway managers. They used the Macintosh, Truview (Truphatek International Ltd, Netanya, Israel), Glidescope (Verathon Inc., Bothell, WA), and Airway Scope (AWS) (Pentax Corporation, Tokyo, Japan) laryngoscopes in normal and difficult simulated airways on manikins on both the table and floor. The time to intubate, modified Cormack-Lehane score, intubation difficulty score, and dental click number were estimated and compared. Results: All 20 medical students completed the study. The AWS required the shortest intubation time, provided the best glottic view and easiest intubation, and resulted in less dental clicks compared with the other 3 laryngoscopes; these phenomena were particularly prominent in the cervical-spine immobilization position on the floor. Although all video laryngoscopes provided better glottic views than the Macintosh laryngoscopy in terms of time to intubate, intubation difficulty score, and the number of dental clicks, the outcomes from the Macintosh laryngoscope were better than those of the Truview and Glidescope. Conclusions: The AWS may have the potential for quicker, easier, and safer tracheal intubation in scenarios involving difficult airways for a novice airway manager.
Journal of Experimental and Clinical Medicine, 2011
This study aims to compare Macintosh laryngoscope and Truview EVO2 video-laryngoscope with respect to the quality of glottic image, the success rate of intubation and their impact on the duration of intubation, hemodynamic responses and also related complications in patients with expected difficult intubation according to the Mallampati scoring system. Sixty patients in ASA I-II group ranging from 18-65 years of age were included in the study. Patients were randomly divided into two groups of 30 cases as group M (the group intubated with Macintosh laryngoscope) and Group V (the group intubated with Truview EVO2 video-laryngoscope). C-L (Cormack-Lehanne) score detected during intubation, duration of intubation, neck extansion needs, the success of intubation, complications, and antihypertensive requirement were recorded. Preoperatively, before induction, after induction, immediately after intubation, after intubation, 1st, 2nd, 3rd, 4th and 5 minute heart rate, systolic artesial pressure, diastolic arterial pressure, mean arterial pressure, peripheral oxygen saturation were recorded. There was a significant difference between both groups as for the quality of glottic images obtained. C-L III score was rated for 1 patient in Group M, and 10 patients in Group V (p<0.05). Duration of intubation was 23 secs in Group M, and 42 secs in Group V, respectively (p<0.05). During intubation neck extension was significantly higher in Group M (p<0.05). Bleeding complication was observed in one patient's mouth during intubation in Group M while no complications were observed in Group V (p>0.05). Number of attempts of intubation, hemodynamic parameters and need for antihypertensive showed no significant difference between the two groups (p>0.05). Truview EVO2 video-laryngoscope may be preferred to Macintosh blade laryngoscope because of better glottic and orafaringeal image acquisition in patients expected with difficult intubation and providing successful intubation in patients with contraindicated neck extension.
IP Innovative Publication Pvt. Ltd., 2018
Introduction and Aims: Currently wide arrays of video laryngoscopes are available to facilitate laryngoscopy and endotracheal intubation in routine and difficult airway patients, intensive care units (ICU) and emergency settings. This study is undertaken to compare the efficacy of C-MAC and King Vision video laryngoscope for easy laryngoscopy and endotracheal intubation in patients with no predictors of difficult airway. Materials and Methods: 60 adult patients undergoing elective surgery were randomly allocated into 2 groups for intubation using either King Vision laryngoscope (KVL group) or C-MAC video laryngoscope (C-MAC group). The parameters recorded were need for external laryngeal manipulation, percentage of glottis opening (POGO score), Cormack Lehane grading, number of attempts and time taken for successful endotracheal intubation and the airway morbidity. Systolic, diastolic, mean blood pressure and heart rate were measured preoperatively and at 1 and 2 min following endotracheal intubation in both the groups. The obtained data were analysed using chi-square test and Student’s t-test using SPSS software. Results: The use of Kings Vision laryngoscope or CMAC video laryngoscope did not differ significantly with respect to good laryngoscopy and intubating conditions. But airway morbidity was significantly lower in the KVL group (10%) when compared with the C-MAC group (40%) p<0> Conclusions: The use of C-MAC or KVL provided excellent laryngoscopy and intubating conditions except for the airway morbidity and haemodynamic stability which were better with the use of KVL. Keywords: Video laryngoscopes, Endotracheal intubation, Airway morbidity, Haemodynamic changes
Academic Emergency Medicine, 2010
Objectives: Video laryngoscopy has been shown to improve glottic exposure when compared to direct laryngoscopy in operating room studies. However, its utility in the hands of emergency physicians (EPs) remains undefined. A simulated difficult airway was used to determine if intubation by EPs using a video Macintosh system resulted in an improved glottic view, was easier, was faster, or was more successful than conventional direct laryngoscopy.
Comparison of direct and video-assisted views of the larynx during routine intubation
Journal of Clinical Anesthesia, 2006
To compare the direct and indirect (video monitor) views of the glottic opening using a new Macintosh blade that is modified to provide a video image of airway structures during laryngoscopy. Design: Prospective multicenter trial. Setting: 11 university-affiliated hospitals. Patients: 867 adults undergoing elective surgery requiring general anesthesia and tracheal intubation. Interventions: Patients received general anesthesia and were paralyzed. Direct laryngoscopy was supervised by one of the investigators at each institution. The best possible view was obtained with a
The Egyptian Journal of Hospital Medicine, 2021
Background: Tracheal intubation is most usually facilitated by the use of a conventional Macintosh laryngoscope. Video and indirect laryngoscopes are becoming more significant tools in the management of the airways in children. Objective: To compare the time of intubation, the number of tries, and the success rate of pediatric intubation by beginner anesthesiologists using a video laryngoscope versus conventional Macintosh laryngoscope. Patients and Methods: This prospective randomized, single-blind clinical was conducted at Zagazig University Hospitals on 52 children aged from 2-6 years who were undergoing elective surgeries. VL Group: (n; 26 patients) intubation using video assisted laryngoscopy (Hugemed type). ML Group: (n; 26 patients) intubation using conventional Macintosh laryngoscope. Duration of intubation, number of trial, hemodynamic response as well as oxygen saturation were recorded at different intervals (base line, after induction, during intubation, after intubation) with assessment of complications. Results: As regard the efficacy and the safety of intubation those patients in ML group had lower intubation time than VL group. There was statistical difference as regard complications of endotracheal intubation as trauma, which was higher in ML group. Conclusion: With the use of a video-aided laryngoscope, it is possible to safely and under supervision to insert an airway into a patient with a difficult airway.