To Compare The Ease Of Tracheal Intubation Using Mcgrath Mac Videolaryngoscope In Direct And Indirect Mode With The Standard Macintosh Laryngoscope: A One Year Randomised Clinical Trail

Abstract

Background and Objectives Video laryngoscopy is becoming a widely accepted airway management. They are described as device helping to reduce peri intubation complication for instance by reducing the amount of intubation attempts and shortening its time. McGrath Video-laryngoscopy (McGrath MAC), is easy to use and enables clinicians to achieve direct and indirect laryngoscopy where required. The McGrath MAC is similar to Macintosh blade in its design it enables clinicians to effectively secure patent airways, even in difficult intubation. The present study was taken up to measure the ease of endotracheal intubation using Mc GRATH MAC videolaryngoscope in direct, indirect mode with Macintosh laryngoscope using intubation difficulty score. Methods The present study is randomized clinical trial, conducted in the department of Anaesthesiology, during the period October 2016- June 2017 at KLE’s Dr.Prabhakar Kore Hospital and Medical Research Center, Nehru Nagar, Belagavi- on 150 patients undergoing general anaesthesia, 50 patients in each group. Intubation was done using McGrath in direct mode, indirect mode and Macintosh group to measure the ease of intubation using Airway Difficulty Score. Results In this study there was no major difference in patient characteristics across the three groups; ADS among the three groups was 7. The majority of the patients were in the age group of 47-50 years. The time taken for intubation using McGrath Videolaryngoscope in indirect mode (25 sec) was lesser than Macintosh group (28sec) whereas direct mode McGrath Videolaryngoscope group (38sec) took the longest of the three groups, which are statically significant. The IDS was seen to be higher in McGrath direct mode 4(0-4[2-6]), where as it was seen that IDS between McGrath indirect1(0-1[0-3]) and Macintosh group1(0-1[0-2]) was comparable. Conclusion and Interpretation The ease of intubation using McGrath videolaryngoscope in indirect mode is better than using McGrath videolaryngoscope in direct mode and is comparable with Macintosh direct laryngoscope. The time taken for intubation using McGrath Videolaryngoscope in indirect mode was lesser than Macintosh group whereas McGrath used as direct mode took the longest of the three groups.