Comparison of McGrath videolaryngoscope with conventional Macintosh laryngoscope for tracheal intubation in pediatric patients with normal airway

Abstract

Background and Aims: Videolaryngoscopes have attained prime importance in securing the airway in children in the present era. McGrath videolaryngoscope is available with single-use non-channeled fog-free disposable blades of various sizes showing its efficacy for intubation in adults but still lacunae in data related to children. Materials and Methods: In this prospective randomized controlled trial, a total of 88 children of the American Society of Anesthesiologists Grade I and II aged 1–10 years, weighing 10–20 kg undergoing general anesthesia were enrolled. Using the sealed envelope technique, the children were randomly allocated between Group G, in whom McGrath videolaryngoscope and Group M, in whom Macintosh laryngoscope was used for intubation. The primary aim was to compare intubation time between the two videolaryngoscopes. The secondary outcomes included glottic exposure time, Cormack and Lehane grading, number of attempts of intubation, intubation difficulty scale and complications. Statistical analysis was done using MedCalc software. The Student's t-test and Chi-square test were used for quantitative and categorical data, respectively. Results: The mean intubation time was comparable in both the groups (18.14 ± 17.80 s in Group G vs. 17.30 ± 16.74 s in Group M, P = 0.821). The mean time to glottic exposure was shorter (5.66 ± 4.58 vs. 8.50 ± 5.59 s, P = 0.0108) with decreased number of attempts of tube insertion and less incidences of trauma observed in patients with Group G as opposed to Group M. The Cormack and Lehane grading showed better glottic view in Group G. Conclusion: McGrath videolaryngoscope is as useful as the Macintosh laryngoscope for intubation in children with the added advantages of a better view of the larynx, lesser attempts to intubation, and fewer incidence of trauma.