A Comparison of McGrath Mac and HugeMed Video Laryngoscopes in Pediatric Patients Under 3 Years Old-A Prospective Randomized Trial.

BACKGROUND

Children generally face a higher incidence of airway management complications, intubation difficulties, and the risk of failed intubation. Currently, there is sufficient evidence in clinical practice for the use of videolaryngoscopes in pediatric airway management. However, there are a number of standard-blade videolaryngoscopes available for children. In addition, there is no clear recommendation on which videolaryngoscope is superior. The primary objective of this study is to compare the first pass success rate and the Percentage of Glottic Opening (POGO) scores with Cormack-Lehane (CML) scores obtained through direct and indirect laryngoscopy with HugeMed and McGrath Mac videolaryngoscopes in pediatric patients with an unanticipated, difficult airway.

MATERIALS AND METHODS

Following the Ethics Committee approval and written parental consents, a total of 40 elective surgical patients, aged 3 and under, with ASA 1-3 risk classification, and undergoing general anesthesia, were included in the study. After induction of general anesthesia, the first group of patients (Group McGrath, = 20) was intubated with the McGrath Mac videolaryngoscope, and the second group (Group HugeMed, = 20) with the HugeMed videolaryngoscope. Before intubation, CML and POGO scores were recorded for both groups using direct and indirect laryngoscopy with videolaryngoscopes. Intubation time, number of attempts, need for cricoid pressure, optimization maneuver requirement, and hemodynamic parameters were recorded for both groups.

RESULTS

There was no significant difference between groups in demographic data including age, gender, body mass index, ASA, and hemodynamic parameters. A significant improvement was observed in CML and POGO scores using indirect laryngoscopy ( < 0.001). CML scores obtained with the McGrath Mac were significantly lower than the HugeMed Group ( = 0.0034). The mean POGO value calculated with indirect laryngoscopy was significantly higher in the McGrath Group compared to the HugeMed Group (92.63 ± 6.09 vs. 88.75 ± 4.44, respectively).

CONCLUSIONS

Videolaryngoscopes improved laryngeal visualization in children under 3 years old. Compared to HugeMed, in indirect laryngoscopy, the McGrath Mac videolaryngoscope was found to be superior, with better CML and POGO scores. However, number of tracheal intubation attempts, success rate, complication risk, and hemodynamic parameters did not show any significant difference between the groups. Clinical trial registration number was NCT06484517.