Usage of a semi-rigid intubation endoscope is not superior to a video laryngoscope. A prospective, randomised, controlled trial comparing the SensaScope vs. the McGrath Series 5 in surgical patients
Section snippets
Background
Patient safety has improved through the development of airway management devices and techniques in the last recent years [[1], [2], [3], [4]]. Recognition of the limitations of direct laryngoscopy has led to the development of intubating devices that do not require a aligning of the oral, pharyngeal and laryngeal axes.
We studied two such non-traditional laryngoscopy techniques: The McGrath Series 5™ (McG; Medtronic®, Dublin, Ireland) is one of the first fully transportable video laryngoscopes
Research ethics approval
The ethics committee of the Medical Association of the State of Rhineland Palatine (Germany) approved this trial (Registration Nr.: 837.330.14 (9569)). This study is registered with ClinicalTrial.gov register number NCT02348736. Written informed consent was obtained from all patients at least one day before randomisation. Patients were randomised to a treatment group using the GraphPad QuickCalcs Web site: http://www.graphpad.com/quickcalcs/randmenu (accessed January 2015). After sample size
Results
From March to May 2015, a total of 76 (McG n = 38; Sc n = 38) adult patients eligible to participate in this study were included (Fig. 2). Intubations with the McG and the Sc were similarly distributed among the patients (p = .9). The patients in the McG group were younger, 34 years [27–56 y], than those in the Sc group, 53.5 years [33.5–63 y] (p = .01). All other patient characteristics were similar (Table 1; p > .05). The distribution of the applications were equal in both groups (McG;
Discussion
In the present study, a faster overall intubation time and a higher first-pass intubation success rate using a video laryngoscope blade (McG) were found in a group of 76 patients. The semi-rigid fibre-optic scope (Sc) did not have any advantages compared to the video laryngoscope (McG). In this trial, visualisation of the glottis and subjective assessment were comparable between the groups. Thus far, this study is one of the first studies comparing the video laryngoscopy with the semi-rigid
Conclusion
To conclude, use of the McG resulted in a significantly faster intubation time and fewer intubation attempts than use of the Sc. Video laryngoscopes in general may offer promise for intubation of the expected normal airway. The use of a semi-rigid fibre-optic does not optimise the tube advancement of anaesthesiologists in a controlled environment. Further studies to compare different video-based laryngoscope blade designs used in patients with different types of airway problems will be useful
Ethical approval and consent to participate
The local Ethical Committee of the Medical Association of the Rhineland Palatine State (Germany, Chairperson: Andrea Wagner, MD; 837.330.14 (9569)) approved this prospective, randomised clinical study (Clinical Trial Register Nr.: NCT02348736). Each patient was given detailed information and provided written informed consent before being included in the study.
Consent to publish
Not applicable. This manuscript does not contain any data on individuals.
Availability of data and materials
The dataset (Microsoft Excel Table; Additional file 1) that
Acknowledgements
The authors wish to thank Irene Schmidtman (Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany). The manuscript contains parts of the doctoral dissertation of Johanna Strauβ, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany.
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