A randomised trial to compare Truview PCD ® , C-MAC ® and Macintosh laryngoscopes in paediatric airway management (original) (raw)
Related papers
Clinics (São Paulo, Brazil), 2014
Videolaryngoscopy has mainly been developed to facilitate difficult airway intubation. However, there is a lack of studies demonstrating this method's efficacy in pediatric patients. The aim of the present study was to compare the TruView infant EVO2 and the C-MAC videolaryngoscope with conventional direct Macintosh laryngoscopy in children with a bodyweight ≤10 kg in terms of intubation conditions and the time to intubation. In total, 65 children with a bodyweight ≤10 kg (0-22 months) who had undergone elective surgery requiring endotracheal intubation were retrospectively analyzed. Our database was screened for intubations with the TruView infant EVO2, the C-MAC videolaryngoscope, and conventional direct Macintosh laryngoscopy. The intubation conditions, the time to intubation, and the oxygen saturation before and after intubation were monitored, and demographic data were recorded. Only children with a bodyweight ≤10 kg were included in the analysis. A total of 23 children wer...
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.
Indian Journal of Anaesthesia, 2013
Background: The Truview EVO2(C) laryngoscope (TL) is a recently introduced optical device designed to provide an unmagnified anterior image of the glottic opening and allow indirect laryngoscopy. Aim: This study is designed to determine whether the TL is a better alternative to the Macintosh laryngoscope (ML) for routine endotracheal intubations in patients with usual airway characteristics. Methods: We compared the Truview EVO2(C) and MLs in 140 elective surgical patients requiring general anaesthesia and intubation in a prospective crossover fashion. The two blades were compared in terms of Cormack and Lehane grades, time required for intubation, anaesthetists' assessment of ease of intubation, intubation difficulty score, attempts at intubation, success rate, soft tissue damage and arterial oxygen saturation during laryngoscopy. The Student t test and Chi-square test were used to determine the statistical significance of parametric data and categorical data, respectively. Results: The Truview EVO2(C) blade provided a better laryngoscopic view than the Macintosh blade as suggested by improved Cormack and Lehane grades (in 48 patients), but required a longer time for intubation than the Macintosh blade (34.1 vs. 22.4 s), i.e., an improved view at the cost of longer mean intubation time. In spite of lower intubation difficulty scores, Truview EVO2(C) was considered as difficult to use on subjective assessment by the anaesthesiologist when compared with Macintosh. There was no difference observed between the two groups in attempts at intubation, success rate, soft tissue damage and arterial oxygen saturation during laryngoscopy. Conclusion: We opine that although Truview provides a better laryngoscopic view than Macintosh in difficult cases, it does not have an extra benefit over Macintosh otherwise, further indicating the need for more experience with the use of a Truview laryngoscope.
The Indian Anaesthetists Forum
Background and Aims: Videolaryngoscopes have attained prime importance in securing the airway in children in the present era. McGrath videolaryngoscope is available with single-use non-channeled fog-free disposable blades of various sizes showing its efficacy for intubation in adults but still lacunae in data related to children. Materials and Methods: In this prospective randomized controlled trial, a total of 88 children of the American Society of Anesthesiologists Grade I and II aged 1-10 years, weighing 10-20 kg undergoing general anesthesia were enrolled. Using the sealed envelope technique, the children were randomly allocated between Group G, in whom McGrath videolaryngoscope and Group M, in whom Macintosh laryngoscope was used for intubation. The primary aim was to compare intubation time between the two videolaryngoscopes. The secondary outcomes included glottic exposure time, Cormack and Lehane grading, number of attempts of intubation, intubation difficulty scale and complications. Statistical analysis was done using MedCalc software. The Student's t-test and Chi-square test were used for quantitative and categorical data, respectively. Results: The mean intubation time was comparable in both the groups (18.14 ± 17.80 s in Group G vs. 17.30 ± 16.74 s in Group M, P = 0.821). The mean time to glottic exposure was shorter (5.66 ± 4.58 vs. 8.50 ± 5.59 s, P = 0.0108) with decreased number of attempts of tube insertion and less incidences of trauma observed in patients with Group G as opposed to Group M. The Cormack and Lehane grading showed better glottic view in Group G. Conclusion: McGrath videolaryngoscope is as useful as the Macintosh laryngoscope for intubation in children with the added advantages of a better view of the larynx, lesser attempts to intubation, and fewer incidence of trauma.
IP innovative publication pvt. ltd, 2019
Introduction: Failure to secure the airway can lead to adverse cardiopulmonary events, brain damage or even anaesthetic death. The advent of various optical or video laryngoscopes have brought about a revolution in airway management. Truview PCD TM laryngoscope is a recently introduced device with a unique blade and prismatic lens which without external manipulation makes visualization of laryngeal inlet much easier. We have therefore compared glottic visualization haemodynamic response and ease of intubation between Truview PCD TM , McCoy and Macintosh laryngoscope blades. Material and Methods: Patients were randomly allocated into three groups of 40 each. Group I-Truview PCD TM laryngoscope, group II-McCoy laryngoscope and group III-Macintosh laryngoscope group. After induction patients were intubated with appropriate blade according to the group allocated. Visualization of laryngeal inlet was graded using Modified Cormack and lehane. Ease of intubation was also graded and hemodynamic parameters were noted on following occasions. Baseline (T1), before induction (T2), after induction (T3), immediately after intubation (T4), 1 min, 3 min and 5 min after intubation (T5,T6 and T7 respectively).
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2013
Introduction The GlideScope Ò video laryngoscope has a 60°angled blade and the blade of the Truview PCD TM video laryngoscope has an optical lens that provides a 46°r efraction of the viewing angle. Despite successful results using the GlideScope in adults, few studies have been published regarding its use in pediatric patients. We therefore tested our joint primary hypothesis that the GlideScope and the Truview PCD video laryngoscopes provide superior visualization to direct laryngoscopy and are non-inferior regarding time to intubation. Methods One hundred thirty-four patients (neonate to ten years of age, American Society of Anesthesiologists physical status I-III) scheduled for general surgical procedures were randomized to tracheal intubation using the Truview PCD or GlideScope video laryngoscope or direct laryngoscopy (Macintosh blade). The laryngoscopic view was scored using the Cormack-Lehane scale. Time to intubation (defined as the time from the moment the device entered the patient's mouth until end-tidal CO 2 was detected) and the number of attempts were recorded. Results The Cormack-Lehane views attained using the GlideScope (P [ 0.99) and Truview PCD (P = 0.18) were not superior to the views attained with direct laryngoscopy. Furthermore, the view attained using the GlideScope was significantly worse than that attained using direct laryngoscopy (P \ 0.001). Fewer patients showed Cormack-Lehane grade I views with the GlideScope than with the Truview PCD (14% vs 82%, respectively; 95% confidence interval [CI]-91% to-46%). The observed median [Q1, Q3] times to intubation were: 39 [31, 59] sec, 44 [28, 62] sec, and 23 [21, 28] sec with the GlideScope, Truview PCD, and direct laryngoscopy, respectively, with median differences of 14 sec (95% CI 7 to 26, GlideScope-direct laryngoscopy) and 17 sec (95% CI 6 to 28, Truview PCDdirect laryngoscopy). Conclusion The Cormack-Lehane views attained using the GlideScope and the Truview PCD video laryngoscopes were not superior to views attained using direct laryngoscopy. Visualization with the GlideScope was significantly worse than with direct laryngoscopy. Use of the GlideScope and Truview PCD systems should be restricted to patients with specific indications.
Journal of Anaesthesiology Clinical Pharmacology, 2011
Background: Background: The Truview EVO2 TM laryngoscope is a recently introduced device with a unique blade that provides a magnified laryngeal view at 42° anterior reflected view. It facilitates visualization of the glottis without alignment of oral, pharyngeal, and tracheal axes. We compared the view obtained at laryngoscopy, intubating conditions and hemodynamic parameters of Truview with Macintosh blade. Materials and Methods: Materials and Methods: In prospective, randomized and controlled manner, 200 patients of ASA I and II of either sex (20-50 years), presenting for surgery requiring tracheal intubation, were assigned to undergo intubation using a Truview or Macintosh laryngoscope. Visualization of the vocal cord, ease of intubation, time taken for intubation, number of attempts, and hemodynamic parameters were evaluated. Results: Results: Truview provided better results for the laryngeal view using Cormack and Lehane grading, particularly in patients with higher airway Mallampati grading (P < 0.05). The time taken for intubation (33.06 ± 5.6 vs. 23.11 ± 57 seconds) was more with Truview than with Macintosh blade (P < 0.01). The Percentage of Glottic Opening (POGO) score was significantly higher (97.26 ± 8) in Truview as that observed with Macintosh blade (83.70 ± 21.5). Hemodynamic parameters increased after tracheal intubation from pre-intubation value (P < 0.05) in both the groups, but they were comparable amongst the groups. No postoperative adverse events were noted. Conclusion: Conclusion: Tracheal intubation using Truview blade provided consistently improved laryngeal view as compared to Macintosh blade without the need to align the oral, pharyngeal and tracheal axes, with equal attempts for successful intubation and similar changes in hemodynamics. However, the time taken for intubation was more with Truview.
2018
Background: We compared intubation conditions, intubation times, and hemodynamic response with the GlideScope video laryngoscope or the Macintosh direct laryngoscope in children older than one year. Methods: In total, 80 patients aged 1–12 years, scheduled to undergo elective surgery under general anesthesia with endotracheal intubation were included in a prospective, randomized trial.After standard anesthesia induction, patients were randomized into two groups.The group G patients(n = 40) were intubated with the GlideScope and the group M patients(n = 40) were intubated with the Macintosh laryngoscope.Intubation time, number of attempts,Cormack–Lehane score, airway maneuvers,visual analog score were recorded. Hemodynamic variables were recorded before and after anesthesia induction, at intubation, and one,three, and five minutes after intubation. Results: The demographic data and operation time were similar between the two groups. The intubation time was longer in Group G. The inci...
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...