Medcaptain® video laryngoscope improves nasotracheal intubation in maxillofacial surgery: A randomized clinical trial

• Published in: Trends in anaesthesia & critical care 2023-10, Vol.52, p.101287, Article 101287
• Main Authors: Ketata, Hind, Zouche, Imen, Sellami, Moncef, Ghars, Oumaima, Ketata, Salma, Charfeddine, Ilhem, Cheikhrouhou, Hichem
• Format: Article
• Language: English
• Subjects: Airway management; Anesthesiology; Intratracheal intubation; Laryngoscopy; Maxillofacial surgery
• ISSN: 2210-8440
• DOI: 10.1016/j.tacc.2023.101287

Nasotracheal intubation may be required to secure the airway in oral and maxillofacial surgery. To evaluate the effectiveness of the video laryngoscope compared with the Macintosh laryngoscope for nasotracheal intubation in maxillofacial surgery. This prospective, randomized, single-blind trial compared the video laryngoscope with the Macintosh laryngoscope for nasotracheal intubation in the adult population. The patients were randomized into two groups: Group M, which underwent intubation with a Macintosh laryngoscope; and Group V, which underwent intubation with a video laryngoscope (Medcaptain®), using an adapted blade (no. 3 for women and no. 4 for men). The modified nasotracheal intubation difficulty scale (NIDS), the three-step evaluation of nasotracheal intubation, the Cormack–Lehane score, the percentage of glottic opening (POGO) scale, and complications were compared. In total, 62 patients (31 in each group) were included in the study. The total intubation duration, oropharynx–glottis time, and glottis–trachea time were significantly lower in Group V compared with Group M (p = 0.001, p = 0.007, and p = 0.008, respectively). Group V also had a significantly lower NIDS score (p = 0.001), a higher POGO score (p = 0.002), and a lower Cormack–Lehane score (p = 0.034) compared with Group M. The use of Magill forceps was less frequent in Group V (p = 0.002). The two groups showed comparable results for nose–oropharynx time, epistaxis, and hoarseness (p = 0.068, p = 0.43, and p = 0.74, respectively). Video laryngoscopy appears to provide easier and faster nasotracheal intubation in maxillofacial surgery. This study was registered in the Pan African Clinical Trials Registry (PACTR) under the reference PACTR202303563303199. •A randomized trial compared the video laryngoscope with the Macintosh laryngoscope for nasotracheal intubation in adults.•The video laryngoscope significatively decreased the frequency of use of Magill forceps during maxillofacial surgery.•The video laryngoscope reduced the intubation time during maxillofacial surgery.