Impacto del uso universal del videolaringoscopio McGrath como primera opción para todas las intubaciones en el quirófano: protocolo del estudio prospectivo, multicéntrico VIDEOLAR-SURGERY con metodología pre-post

Abstract

Introduction

Usual tracheal intubation performed in the operating room is based on direct laryngoscopy, using a standard Macintosh laryngoscope. Several authors recommend the universal use of a videolaryngoscope as the first option for all intubations, regardless of whether the patient has predictors of a difficult airway or not. We hypothesize that using the McGrath videolaryngoscope as the first intubation option increases the frequency of patients with easy intubation, and decreases complications associated to the intubation.

Methods and analysis

The VIDEOLAR-SURGERY trial is a prospective, multicenter, open-label, interventional, before-after study. In the pre-implementation period (non-interventional phase, 6-9 months [2600 intubations]), 35 anesthesiologists from 8 hospitals perform all tracheal intubations for an elective or urgent surgical procedure using the standard Macintosh direct laryngoscope as the first intubation option. During the implementation period (2 months), a McGrath Mac videolaryngoscope is provided to each anesthesiologist to train in its use. During the post-implementation period (interventional-phase, 6-9 months [2600 intubations]), the 35 anesthesiologists perform all tracheal intubations using a McGrath Mac videolaryngoscope as the first intubation option. The main objective of present study is to evaluate whether the use of a McGrath Mac videolaryngoscope as the first intubation option, improves the percentage of patients with easy intubation compared with the standard Macintosh laryngoscope.

Ethics and dissemination

The study protocol was approved May 2, 2023, by the Ethics Committee of Galicia, Spain (CEI-SL, code No. 2023-177), and was registered into the Clinicaltrials.gov clinical trials registry with No. NCT NCT05850260. Informed consent is required. The results will be submitted for publication in a peer-reviewed journal and presented at one or more scientific conferences. If videolaryngoscope improves easy intubation compared with Macintosh direct laryngoscope when it is used for all intubations in operating room, its use may will become standard practice, thereby decreasing complications associated with the intubation procedure.