A comparison of the McGrath videolaryngoscope with direct laryngoscopy for rapid sequence intubation in the operating theatre: a multicentre randomised controlled trial

Summary Aspiration of gastric contents is a recognised complication during all phases of anaesthesia. The risk of this event becomes more likely with repeated attempts at tracheal intubation. There is a lack of clinical data on the effectiveness of videolaryngoscopy relative to direct laryngoscopy r...

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Bibliographic Details
Published in:Anaesthesia 2024-08, Vol.79 (8), p.801-809
Main Authors: Kriege, M., Lang, P., Lang, C., Schmidtmann, I., Kunitz, O., Roth, M., Strate, M., Schmutz, A., Vits, E., Balogh, O., Jänig, C.
Format: Article
Language:English
Subjects:
Adult
Aged
airway management
Anesthesia
Female
Humans
Intubation
Intubation, Intratracheal - instrumentation
Intubation, Intratracheal - methods
Laryngoscopes
Laryngoscopy
Laryngoscopy - instrumentation
Laryngoscopy - methods
Macintosh personal computers
Male
Medical instruments
Middle Aged
Operating Rooms
Patients
rapid sequence induction
Rapid Sequence Induction and Intubation - methods
Risk management
tracheal intubation
Video-Assisted Techniques and Procedures
videolaryngoscopy
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Summary:Summary Aspiration of gastric contents is a recognised complication during all phases of anaesthesia. The risk of this event becomes more likely with repeated attempts at tracheal intubation. There is a lack of clinical data on the effectiveness of videolaryngoscopy relative to direct laryngoscopy rapid sequence intubation in the operating theatre. We hypothesised that the use of a videolaryngoscope during rapid sequence intubation would be associated with a higher first pass tracheal intubation success rate than conventional direct laryngoscopy. In this multicentre randomised controlled trial, 1000 adult patients requiring tracheal intubation for elective, urgent or emergency surgery were allocated randomly to airway management using a McGrath™ MAC videolaryngoscope (Medtronic, Minneapolis, MN, USA) or direct laryngoscopy. Both techniques used a Macintosh blade. First‐pass tracheal intubation success was higher in patients allocated to the McGrath group (470/500, 94%) compared with those allocated to the direct laryngoscopy group (358/500, 71.6%), odds ratio (95%CI) 1.31 (1.23–1.39); p 
ISSN:0003-2409
1365-2044
1365-2044
DOI:10.1111/anae.16250