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Published on: June 6, 2020
Comparison of McGrath Videolaryngoscope and Macintosh Laryngoscope in Children with Torticollis: Randomized
Min Hur1, Jong Yeop Kim1, Sang Kee Min1
1Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon 16499, Korea.
Insights
The McGrath videolaryngoscope took longer for intubation than the Macintosh laryngoscope in children with torticollis. While easier to use, it did not improve glottic visualization during pediatric airway management.
Area of Science:
- Anesthesiology
- Pediatric Surgery
Background:
- Pediatric airway management presents unique challenges.
- Torticollis can complicate endotracheal intubation.
- Videolaryngoscopes offer potential advantages over traditional laryngoscopes.
Purpose of the Study:
- To compare the efficacy of the McGrath videolaryngoscope versus the Macintosh laryngoscope for orotracheal intubation in children with torticollis.
- To evaluate intubation time, glottic visualization, and ease of use.
Main Methods:
- A randomized controlled trial involving 30 children (aged 1-10 years) undergoing torticollis surgery.
- Comparison of McGrath videolaryngoscope and Macintosh laryngoscope for intubation by a skilled anesthesiologist.
- Assessment of primary outcome (intubation time) and secondary outcomes (Cormack-Lehane grade, lifting force, Intubation Difficulty Scale [IDS], success rate).
Main Results:
- Intubation time was significantly longer with the McGrath videolaryngoscope (31.4 ± 6.7 s) compared to the Macintosh laryngoscope (26.1 ± 5.4 s; p=0.025).
- Lifting force and IDS were significantly lower with the McGrath videolaryngoscope (p<0.001 and p=0.022, respectively).
- Glottic visualization (Cormack-Lehane grade), intubation difficulty, and success rates were comparable between the two devices.
Conclusions:
- The McGrath videolaryngoscope did not reduce intubation time or improve glottic visualization compared to the Macintosh laryngoscope in pediatric torticollis patients.
- Despite lower force and difficulty scores, the McGrath videolaryngoscope offers no clear advantage for this specific patient population.
- Further research may be needed to identify specific pediatric airway scenarios where videolaryngoscopes provide superior outcomes.
Abstract:
We investigated the efficacy of the McGrath videolaryngoscope compared with the Macintosh laryngoscope in children with torticollis. Thirty children aged 1-10 years who underwent surgical release of torticollis were randomly assigned into the McGrath and Macintosh groups. Orotracheal intubation was performed by a skilled anesthesiologist. The primary outcome was the intubation time. The Cormack-Lehane grade, lifting force, intubation difficulty scale (IDS), difficulty level, and intubation failure rate were also assessed. The intubation time was significantly longer in the McGrath group than in the Macintosh group (31.4 ± 6.7 s vs. 26.1 ± 5.4 s, p = 0.025). Additionally, the Cormack-Lehane grades were comparable between the groups (p = 0.101). The lifting force and IDS were significantly lower in the McGrath group than in the Macintosh group (p < 0.001 and p = 0.022, respectively). No significant differences were observed with respect to endotracheal intubation difficulty and intubation success rate. Intubation-related complications were also not observed. In conclusion, compared with the Macintosh laryngoscope, the McGrath videolaryngoscope extended the intubation time and did not improve glottic visualization in children with torticollis, despite having a lesser lifting force, lower intubation difficulty scale, and similar success rate.
