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Efficacy of McGRATH®MAC videolaryngoscope blade 1 for tracheal intubation in small children: a randomized controlled clinical study

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Abstract

Background

Videolaryngoscopes may not be as effective in small children as they are in older children and in adults. The size 1 blade is commercially available for the McGRATH®MAC videolaryngoscope (Covidien, Medtronic, Tokyo, Japan), but its efficacy in comparison with a Macintosh laryngoscope blade 1 is not known.

Aim

The main aim of this study was to assess the efficacy of McGrath®MAC blade 1 in comparison with a conventional Macintosh laryngoscope blade 1, in children aged less than 24 months.

Methods

Thirty-eight children aged less than 24 months were randomly allocated to one of two groups, and tracheal intubation was attempted using either a direct laryngoscope with a Macintosh blade 1 or a videolaryngoscope with a McGRATH®MAC blade 1. In another 12 children aged 2–4 years, the same comparisons were made with blade 2. The primary outcome measure was time to tracheal intubation using a size 1 blade.

Results

Tracheal intubation took significantly longer with a McGRATH®MAC blade 1 (median (interquartile range): 38.0 (31.8–43.5) s) than with the Macintosh blade 1(27.4 (25.9–29.2) s) (p < 0.0001; median difference (95% CI for the median difference): 10.6 (6.4–14.0) s), mainly due to difficulty in advancing a tube into the trachea. No significant difference was observed for the size 2.

Conclusions

In small children without predicted difficult airways, time to intubate the trachea was significantly longer for a McGRATH®MAC blade 1 than a Macintosh blade 1.

Clinical trial registration

jRCT1032220366.

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Authors and Affiliations

  1. Department of Anesthesiology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya City, Saitama, 343-8555, Japan

    Katsuhide Masui, Takashi Asai, Tomoyuki Saito & Yasuhisa Okuda

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  1. Katsuhide Masui
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  2. Takashi Asai
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  3. Tomoyuki Saito
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  4. Yasuhisa Okuda
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Correspondence to Katsuhide Masui.

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Masui, K., Asai, T., Saito, T. et al. Efficacy of McGRATH®MAC videolaryngoscope blade 1 for tracheal intubation in small children: a randomized controlled clinical study. J Anesth 37, 582–588 (2023). https://doi.org/10.1007/s00540-023-03207-2

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  • DOI: https://doi.org/10.1007/s00540-023-03207-2

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