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An evaluation of a modified Macintosh laryngoscope in a manikin
M J Bucx1, C J Snijders, M H van der Vegt
1Department of Anaesthesia, Academic Medical Center, University of Amsterdam, Erasmus University Rotterdam, The Netherlands.
Purpose:
In this manikin study a modified Macintosh blade was prospectively compared with its original focussing on the forces exerted on the maxillary incisor teeth and intubation success. The modified blade, a standard Macintosh blade with a reduced proximal flange, was intended to reduce the forces exerted on the maxillary incisors.
Methods:
A manikin equipped with two sensors, to measure forces applied to the maxillary incisors in the axial and the transverse direction, was used. Fourteen staff anaesthetists and 16 residents each performed two laryngoscopies with both blades.
Results:
All laryngoscopies resulted in successful tracheal intubation. The maximal and mean forces exerted on the teeth in the axial direction were 12 N and 5.8 N smaller (P < 0.0005 and P < 0.0005, respectively) when the modified blade was used.
Conclusion:
The use of the modified blade resulted in a reduction of the forces on the maxillary incisors whereas the intubation success rate was the same as with the original. Studies in manikins can be useful in comparative laryngoscope testing.
Insights
A modified Macintosh laryngoscope blade significantly reduced forces on maxillary incisor teeth during intubation. This innovation maintained high intubation success rates, offering a safer option for dental protection during airway management.
Area of Science:
- Anesthesiology
- Medical Device Engineering
Background:
- Dental trauma is a risk during endotracheal intubation.
- Macintosh laryngoscope blades are commonly used for airway management.
- Modifications to laryngoscope blades may reduce forces on teeth.
Purpose of the Study:
- To compare a modified Macintosh blade with a reduced proximal flange against the original blade.
- To evaluate the forces exerted on maxillary incisor teeth during laryngoscopy.
- To assess the impact on tracheal intubation success rates.
Main Methods:
- A manikin study utilizing sensors to measure axial and transverse forces on maxillary incisors.
- Fourteen staff anesthetists and 16 residents performed laryngoscopies with both blade types.
- Each participant performed two laryngoscopies with each blade.
Main Results:
- All laryngoscopies achieved successful tracheal intubation.
- The modified blade reduced maximal axial forces by 12 N (P < 0.0005).
- The modified blade reduced mean axial forces by 5.8 N (P < 0.0005).
Conclusions:
- The modified Macintosh blade effectively reduces forces on maxillary incisors.
- Intubation success rates were comparable between the modified and original blades.
- Manikin studies are valuable for comparative laryngoscope testing.