{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:55:10Z","timestamp":1787028910666,"version":"build-2736575974"},"reference-count":24,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T00:00:00Z","timestamp":1675123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Difficult intubation, which may be encountered unexpectedly during anesthesia, can increase patients\u2019 morbidity and mortality. The McGRATH video laryngoscope is known to provide improved laryngeal visibility in patients with difficult or normal airways. The purpose of this study was to evaluate the efficacy of the McGRATH video laryngoscope for orotracheal intubation compared with that of conventional Macintosh laryngoscopes in simulated difficult airway scenarios. Materials and Methods: In this randomized controlled trial, patients who were scheduled for surgery under general anesthesia requiring orotracheal intubation were assigned to the Macintosh laryngoscope (n = 50) or McGRATH video laryngoscope (n = 45) groups. In this study, to create a simulated difficult airway condition, the subjects performed manual in-line stabilization and applied a soft cervical collar. The primary outcome was the rate of successful intubation within 30 s. The time required for an intubation, glottis grade, intubation difficulty scale (IDS score), the subjective ease of intubation, and optimal external laryngeal manipulation (OLEM) were evaluated. In addition, complications caused by each blade were investigated. Results: The intubation success rate within 30 s was not significantly different between the two groups (44 (88.0%) vs. 36 (80.0%), p = 0.286). The glottic grade was better in the McGRATH group than in the Macintosh group (p = 0.029), but neither the intubation time (26.3 \u00b1 8.2 s vs. 24.2 \u00b1 5.0 s, p = 0.134) nor the rates of oral bleeding (2 (4.0%) vs. 0 (0.0%)) and tooth injury (0 (0.0%) vs. 1 (2.2%)) were significantly different between the two groups. Conclusions: The use of the McGRATH video laryngoscope did not improve the intubation success rate or shorten the intubation time. However, the McGRATH video laryngoscope provided a better glottis view than the conventional Macintosh laryngoscope in patients with a simulated difficult airway.<\/jats:p>","DOI":"10.3390\/medicina59020282","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T02:52:02Z","timestamp":1675219922000},"page":"282","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of the McGRATHTM Video Laryngoscope and Macintosh Laryngoscope for Orotracheal Intubation in a Simulated Difficult Airway Scenario: An Open-Label, Randomized Clinical Trial"],"prefix":"10.3390","volume":"59","author":[{"given":"Jong-Yeop","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, School of Medicine, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seonghyeok","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, School of Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minho","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, School of Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2277-1095","authenticated-orcid":false,"given":"Jong-Bun","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, School of Medicine, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Ji","family":"John","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, School of Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo-Kyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, School of Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6055-3473","authenticated-orcid":false,"given":"Yi-Hwa","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, School of Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1093\/bja\/aer058","article-title":"Major complications of airway management in the UK: Results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia","volume":"106","author":"Cook","year":"2011","journal-title":"Br. J. Anaesth."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1111\/j.1365-2044.2004.04013.x","article-title":"The Glidescope system: A clinical assessment of performance","volume":"60","author":"Rai","year":"2005","journal-title":"Anaesthesia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1097\/ALN.0b013e318246e866","article-title":"Videolaryngoscopes: Do they truly have roles in difficult airways?","volume":"116","author":"Asai","year":"2012","journal-title":"Anesthesiology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1046\/j.1365-2044.2003.03207_7.x","article-title":"Training method of applying pressure on the neck for laryngoscopy: Use of a videolaryngo-scope","volume":"58","author":"Asai","year":"2003","journal-title":"Anaesthesia"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/BF03022777","article-title":"Case series: The McGrath videolaryngoscope\u2014An initial clinical evaluation","volume":"54","author":"Shippey","year":"2007","journal-title":"Can. J. Anaesth."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1093\/bja\/aem303","article-title":"Use of the McGrath videolaryngoscope in the management of difficult and failed tracheal intubation","volume":"100","author":"Shippey","year":"2008","journal-title":"Br. J. Anaesth."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1111\/anae.13384","article-title":"A randomised cross-over trial comparing the McGrath(\u00ae) Series 5 videolaryngo-scope with the Macintosh laryngoscope in patients with cervical spine immobilisation","volume":"71","author":"Foulds","year":"2016","journal-title":"Anaesthesia"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/anae.12075","article-title":"The McGrath\u00ae Series 5 videolaryngoscope vs the Macintosh laryngoscope: A randomised, controlled trial in patients with a simulated difficult airway","volume":"68","author":"Taylor","year":"2013","journal-title":"Anaesthesia"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1111\/anae.12804","article-title":"A prospective randomised controlled trial comparing tra-cheal intubation plus manual in-line stabilisation of the cervical spine using the Macintosh laryngoscope vs the McGrath(\u00ae) Series 5 videolaryngoscope","volume":"69","author":"Ilyas","year":"2014","journal-title":"Anaesthesia"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e8713","DOI":"10.1097\/MD.0000000000008713","article-title":"Comparison of the Pentax AirwayScope and McGrath MAC videolaryngoscope for endotracheal intubation in patients with a normal airway","volume":"96","author":"Lee","year":"2017","journal-title":"Medicine"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e19645","DOI":"10.1097\/MD.0000000000019645","article-title":"Two head positions for orotracheal intubation with the trachway videolight intubating stylet with manual in-line stabilization: A randomized controlled trial","volume":"99","author":"Chan","year":"2020","journal-title":"Medicine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1111\/j.1399-6576.2010.02363.x","article-title":"Evaluation of the Pentax-AWS(\u00ae) and the Macintosh laryngoscope in difficult intubation: A manikin study","volume":"55","author":"Kariya","year":"2011","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1213\/ANE.0b013e3181b7303a","article-title":"A comparison of three videolaryngoscopes: The Macintosh laryngoscope blade reduces, but does not, routine stylet use for intubation in morbidly obese patients","volume":"109","author":"Maassen","year":"2009","journal-title":"Anesth. Analg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1093\/bja\/aep191","article-title":"Randomized controlled trial of intubation with the McGrath Series 5 videolaryngoscope by inexperienced anaesthetists","volume":"103","author":"Walker","year":"2009","journal-title":"Br. J. Anaesth."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1093\/bja\/aew058","article-title":"Evaluation of six videolaryngo-scopes in 720 patients with a simulated difficult airway: A multicentre randomized controlled trial","volume":"116","author":"Greif","year":"2016","journal-title":"Br. J. Anaesth."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jclinane.2017.12.030","article-title":"McGrath videolaryngoscope versus Macintosh laryngoscope for tracheal intubation: A systematic review and meta-analysis with trial sequential analysis","volume":"46","author":"Hoshijima","year":"2018","journal-title":"J. Clin. Anesth."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1111\/j.1399-6576.2010.02285.x","article-title":"Video-laryngoscope in the adult airway management: A topical review of the literature","volume":"54","author":"Niforopoulou","year":"2010","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1097\/EJA.0b013e32834a34f3","article-title":"Comparison of video laryngoscopes with direct laryngoscopy for tracheal intu-bation: A meta-analysis of randomised trials","volume":"28","author":"Su","year":"2011","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.joms.2015.07.021","article-title":"McGrath Video Laryngoscopy Facilitates Routine Nasotracheal In-tubation in Patients Undergoing Oral and Maxillofacial Surgery: A Comparison with Macintosh Laryngoscopy","volume":"74","author":"Kwak","year":"2016","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1007\/s12630-019-01409-5","article-title":"Randomized comparison of McGrath MAC videolaryngoscope, Pentax Air-way Scope, and Macintosh direct laryngoscope for nasotracheal intubation in patients with manual in-line stabilization","volume":"66","author":"Roh","year":"2019","journal-title":"Can. J. Anaesth."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/ALN.0000000000004002","article-title":"2022 American Society of Anesthesiologists practice guidelines for management of the difficult airway","volume":"136","author":"Apfelbaum","year":"2022","journal-title":"Anesthesiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1097\/00000542-199712000-00005","article-title":"The intubation difficulty scale (IDS): Proposal and evaluation of a new score characterizing the complexity of endotracheal intubation","volume":"87","author":"Adnet","year":"1997","journal-title":"Anesthesiology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1007\/s12630-016-0654-6","article-title":"A deliberately restricted laryngeal view with the GlideScope\u00ae video laryngoscope is associated with faster and easier tracheal intubation when compared with a full glottic view: A randomized clinical trial","volume":"63","author":"Gu","year":"2016","journal-title":"Can. J. Anaesth."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1111\/j.1365-2044.2012.07087.x","article-title":"Measurement of forces applied during Macintosh direct laryngoscpy compared with GlideScope\u00ae videolaryngoscopy","volume":"67","author":"Russel","year":"2012","journal-title":"Anaesthesia"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/2\/282\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:20:16Z","timestamp":1760120416000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/2\/282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,31]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["medicina59020282"],"URL":"https:\/\/doi.org\/10.3390\/medicina59020282","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,31]]}}}