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A randomised trial to compare Truview PCD®, C-MAC® and Macintosh laryngoscopes in paediatric airway management

Ranju Singh1, Nishant Kumar1, Aruna Jain1

  • 1Department of Anaesthesiology & Critical Care, Lady Hardinge Medical College & Associated Shrimati Sucheta Kriplani Hospital, New Delhi, India.

Asian Journal of Anesthesiology
|October 4, 2017
PubMed

Insights

The Truview PCD laryngoscope offers an excellent view of the glottic opening in paediatric patients, with a mean intubation time under 20 seconds. This study found it suitable for paediatric intubation compared to C-MAC and Macintosh devices.

Area of Science:

  • Anesthesiology
  • Pediatric Airway Management

Background:

  • Effective laryngoscopy and intubation are critical in pediatric anesthesia.
  • Standard Macintosh laryngoscopes may present challenges in visualizing the glottis in children.
  • Novel laryngoscopes aim to improve glottic visualization and intubation success rates.

Purpose of the Study:

  • To compare the efficacy of the Truview PCD and C-MAC laryngoscopes against the standard Macintosh laryngoscope for endotracheal intubation in pediatric patients.
  • To evaluate key intubation parameters including glottic visualization, time, and complications.

Main Methods:

  • A randomized controlled trial involving 150 pediatric patients (1-6 years, 10-20 kg) undergoing elective surgery.
  • Patients were randomized into three equal groups using Truview PCD, C-MAC, or Macintosh laryngoscopes under general anesthesia.
  • Outcomes measured included Percentage of Glottic Opening (POGO) score, need for External Laryngeal Maneuver (ELM), intubation time, attempts, failed intubations, desaturation, and trauma.

Main Results:

  • Truview PCD demonstrated significantly better POGO scores compared to C-MAC and Macintosh (94.7 vs. 82.0 vs. 85.1; p < 0.01).
  • Mean intubation times were 19.2s (Truview PCD), 12.3s (C-MAC), and 10.7s (Macintosh), with significant differences among groups (p < 0.01).
  • Fewer patients required external laryngeal maneuver with Truview PCD (8/50) compared to C-MAC (21/50) and Macintosh (19/50) (p < 0.01). No failed intubations, desaturations, or trauma were reported.

Conclusions:

  • The Truview PCD laryngoscope provides an excellent view of the glottic opening in pediatric patients, facilitating intubation.
  • With a mean intubation time under 20 seconds and suitability for pediatric use, Truview PCD is a valuable tool for pediatric airway management.
  • Comparison highlights Truview PCD's advantages in glottic visualization and reduced need for external laryngeal maneuvers in this population.
Abstract

Keywords:
C-MACLaryngoscopesMacintoshPOGOTruview PCD

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