Airway management remains one of the most important tasks of the anesthesiologist. Intubation problems can lead to serious and sometimes life-threatening complications. Oxygen deprivation during anesthesia is the most common cause of death and permanent brain damage.1,2 Traditional direct laryngoscopy with a Macintosh Laryngoscopes is the standard technique for endotracheal tube placement.
However, this skill is not easy to learn and requires adequate training.3,4 Difficulties with tracheal intubation are often unpredictable and occur most frequently in inexperienced anesthesiologists. Due to a lack of technique and experience, they may have difficulty even with conventional airway intubation.
Therefore, less experienced anesthesiologists are more likely to perform difficult or failed fine airway intubations, which can lead to prolonged intubation times, anoxia, and even more adverse outcomes, especially when working without direct supervision.
Video laryngoscopy is becoming a widely accepted airway management technique. Compared with conventional direct Macintosh Laryngoscopes, it provides better visualization of the glottis in both normal and difficult airways.6-8 The McGrath Series 3 video laryngoscope (Aircraft Medical, Edinburgh, Scotland) is a new, stand-alone video laryngoscope with a disposable sterile, clear, 45° angled acrylic slide (110 mm × 12 mm × 15 mm).
It has a small camera at the tip of the blade and a battery-powered light source located in the handle, thus offering the advantages of a standalone device without the need for separate power supplies, displays or cables.
The McGrath provides a clear view of the anatomy of the glottis, vocal cords, and surrounding airways on a handle-mounted LCD display, without the need to align the mouth, pharynx, and larynx in patients with normal and potentially difficult airways.9,10 It is also used for failed tracheal intubation with Macintosh and other laryngoscopes.11,12
However, there is little information on its use by inexperienced anesthesiologists. The McGrath resembles a Macintosh in design and blade shape and is easily understood by novices. In addition, experienced anesthesiologists can observe and be guided through the actual intubation procedure from the screen.13,14 Therefore, it appears to be a good training tool and may provide a safer and simpler intubation device for less experienced anesthesiologists.
This study examined the performance of the McGrath compared with the Macintosh (Diamond Fibrelight, Penlon, Abingdon, UK) when used by inexperienced anesthesiologists during uncomplicated orotracheal intubation.
We hypothesized that the McGrath might be a better choice because of its shorter intubation time and better visualization than the Macintosh. We also wanted to evaluate the safety of the devices in terms of hemodynamic and intubation complications and the ease of intubation as assessed by inexperienced anesthetists.