Tracheal intubation with the McGrath MAC X-blade videolaryngoscope in morbidly obese and nonobese patients

Abstract

Background/aim: Increased body mass index (BMI) and neck circumference are the two independent predictors of difficult intubation.McGrath MAC X-Blade is a videolaryngoscope specifically designed for difficult intubations.Materials and methods: Eighty patients with the American Society of Anesthesiologists (ASA) physical status I–III undergoing electivesurgery requiring endotracheal intubation were enrolled in the study. Patients were divided into two groups, nonobese (BMI 35). All patients were intubated with the McGrath MAC X-Blade in both groups. View optimization and tubeinsertion maneuvers such as reinsertion of the device, slight removal of the device, cricoid pressure, handling force, 90° anticlockwiserotation of the tube, use of stylet, and head flexion maneuvers were recorded. Cormack–Lehane grades, insertion times, intubation, andtotal intubation times were recorded. The hemodynamic changes and postoperative minor complications were also recorded.Results: Body mass index, neck circumference, Mallampati scores, and ASA physical status were statistically higher in the morbidlyobese group (P 35) patients with the aid of some key maneuvers and with a statistically significant but clinically negligible prolongation of theintubation time.