Effect of head and neck positions on tracheal intubation using a McGRATH MAC video laryngoscope: A randomised, prospective study
Authors' conclusion
The head elevation position facilitated tracheal intubation using a McGRATH MAC video laryngoscope compared with a simple head extension or sniffing position.
Study context
- Population
- Patients undergoing GA, intubated with a McGRATH MAC video laryngoscope; university tertiary hospital centre
- Participants
- 174 patients
- Comparison
- Simple head extension vs Head elevation only vs Sniffing position
- Primary endpoint
- Intubation difficulty (modified intubation difficulty scale score)
Methodological detailsprospective, three-arm
- Prospective
- Three-arm
Primary result
As reported in the abstract
Intubation difficulty
- Head elevation only vs Simple head extension: P = 0.001
- Head elevation only vs Sniffing position: P = 0.011
- Simple head extension vs Sniffing position: P = 0.252
Further findings
| Outcome | P value |
|---|---|
| Time taken for intubationHead elevation only vs Simple head extension · significantly shorter with head elevation | P < 0.001 |
| Need for lifting force or laryngeal pressure for tube advancement into the glottisHead elevation only vs Simple head extension · required less frequently with head elevation | P = 0.002 |
| Need for lifting force or laryngeal pressure for tube advancement into the glottisHead elevation only vs Sniffing position · required less frequently with head elevation | P = 0.012 |
| Need for lifting force or laryngeal pressure for tube advancement into the glottisSimple head extension vs Sniffing position · not significantly different | P = 0.498 |
Safety
| Outcome | P value |
|---|---|
| Palatopharyngeal mucosal injuryHead elevation only vs Simple head extension · occurred less frequently with head elevation | P = 0.009 |
Original publication
Effect of head and neck positions on tracheal intubation using a McGRATH MAC video laryngoscope: A randomised, prospective study. Eur J Anaesthesiol. Published 13 April 2023. doi:10.
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