A Comparative clinical study to evaluate intubating conditions between mediminers videolaryngoscope and mccoy blade in difficult intubation : a randomised controlled single blinded trail

Abstract

Background

Effective airway management remains one of the most important responsibilities of the anesthesiologist, particularly in patients with anticipated difficult airways. Although the McCoy laryngoscope has been widely used to improve glottic visualization through its hinged levering tip, successful intubation still depends on optimal alignment of the oral, pharyngeal, and laryngeal axes. Video laryngoscopes have revolutionized airway management by providing an indirect view of the glottis, thereby facilitating tracheal intubation with minimal airway manipulation. The mediminers video laryngoscope is a recently introduced, cost-effective video laryngoscope with limited published clinical evidence. The present study was undertaken to compare the mediminers video laryngoscope with the McCoy laryngoscope in patients with anticipated difficult airways.   

Methods

This prospective randomized controlled single-blinded study included 90 adult patients (ASA physical status I–II) (American society anesthesiologist ) aged 18–55 years with anticipated difficult airway (Modified Mallampati Grade III or IV) or cervical spine instability undergoing elective surgery under general anesthesia requiring endotracheal intubation. Patients were randomly allocated into two groups of 45 each: Group V (mediminers video laryngoscope) and Group M (McCoy laryngoscope). The primary outcome was the Intubation Difficulty Scale (IDS) score. Secondary outcomes included Cormack–Lehane grade, time to glottic visualization, total intubation time, ease of intubation, requirement for external laryngeal manipulation, first-pass success, and hemodynamic responses.

Results

The mediminers video laryngoscope demonstrated significantly lower IDS scores compared with the McCoy laryngoscope (median 1 vs. 4, p<0.001). Patients in the mediminers group achieved superior glottic visualization, shorter laryngoscopy and intubation times, higher first-pass success rates, improved ease of intubation, and significantly fewer optimization maneuvers. Hemodynamic responses following laryngoscopy and tracheal intubation were also significantly attenuated in the mediminers group.

Conclusion

The mediminers video laryngoscope provided superior intubating conditions compared with the McCoy laryngoscope in patients with anticipated difficult airways. Improved glottic visualization, reduced intubation difficulty, shorter procedural duration,and better hemodynamic stability suggest that the mediminers video laryngoscope is an effective alternative for the management of anticipated difficult airway.