Comparison of direct laryngoscope and McGrath videolaryngoscope in terms of glottic view and hemodynamics in bariatric surgery

Abstract

Background/aim: In the recent years, videolaryngoscopes (VL) have emerged as alternative devices to direct laryngoscopes (DL) indifficult intubation situations. Therefore, we aimed to compare the Macintosh DL and McGrath VL in terms of the glottic image quality,intubation success, intubation time, hemodynamic response after intubation, and complications in bariatric surgery patients.Material and methods: After obtaining approval by the ethics committee and receiving informed consent, we recorded the demographicand physical data of patients undergoing bariatric surgery. Patients were divided into 2 groups: Group M was intubated with theMacintosh DL, and Group V was intubated with the McGrath VL. After intubation, we noted the Cormack–Lehane score, the durationof intubation, the number of intubation interventions, and the hemodynamic data of patients.Results: A total of 62 patients (ASA II, body mass index of >35 kg/m2) were included in the study. All patients except 1 patient wereintubated on the first attempt. Although there was a decrease in heart rate and blood pressure with induction, similar hemodynamic datawere obtained between groups during the operation. In group V, we obtained a better glottic image (P = 0.011), but intubation successwas similar between the study groups. We also measured the intubation time in group M as 45.9 ± 19.1 s and group V as 57.1 ± 15.8 s(P = 0.015).Discussion: Although we measured longer intubation times with the McGrath VL compared with the Macintosh DL, we obtained abetter glottic image without causing hemodynamic changes. However, these findings did not make any difference in terms of intubationsuccess.