A randomized, crossover model-based study of five different laryngoscopes in normal airway scenario
Ayten Saraçoğlu1, Engin Hüsnü Uğur1, Olgaç Bezen2, Sibel Şener2, Fisun Yüzer1, Nüzhet Mert Şentürk3
1Department of Anaesthesiology and Reanimation, Medical Faculty of İstanbul Bilim University, İstanbul, Turkey
2Department of Anaesthesiology and Reanimation, İstanbul Bilim University Health Services Vocational High School, İstanbul, Turkey
3Department of Anaesthesiology and Reanimation, İstanbul University İstanbul Medical School, İstanbul, Turkey
Keywords: Airway; intubation; laryngoscope.
Abstract
Objectives: Direct laryngoscopy is a conventional method that has been taught in endotracheal intubation training. However, it is difficult to become skilled. Videolaryngoscopy has become a widely accepted technique for training both novice and inexperienced medical staff on airway management. We aimed to compare the performances of novices using direct and indirect laryngoscopes.
Materials and methods: Fifty eight first-year anesthesia nurse students without previous tracheal intubation experience were included in the study. Standard size 3 Macintosh, Miller, McCoy, McGrath, Storz C-Mac laryngoscopes were used. The participants were asked to intubate the AirMan manikin five times with each device. The participants were also asked for their familiarity with computer games. After all the students completed their fifth intubations; the duration of successful tracheal intubation, number of attempts, success rate, severity of the dental trauma, and the used optimization maneuvers were recorded in the course of students’ sixth intubations.
Results: Time to successful intubation was the shortest for C-Mac laryngoscope with 5.34±2.19 sec. The requirement of optimization maneuvers (12.1%) and additional intubation attempts (1.7%) were significantly lower with C-Mac and McGrath laryngoscopes compared to Macintosh, Miller and McCoy laryngoscopes (p<0.001). Dental trauma incidence was significantly lower during the use of C-Mac laryngoscope (p<0.001). The VAS score on the ease of intubation were significantly lower with C-Mac laryngoscope. No advantages related to the familiarity with computer games were documented.
Conclusion: In conclusion, C-Mac was observed to provide a higher overall success rate for tracheal intubation and less dental trauma incidence when it was used in a normal airway scenario.