Visual rigid laryngoscope versus Macintosh laryngoscope using low-dose relaxants in thyroid surgery.
Weihuang Qiu, Tingjie Wang, Lijun Weng et al.
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In 30 seconds
This single-centre randomized controlled trial compared visual rigid laryngoscopy (VRL) with Macintosh laryngoscopy for tracheal intubation in patients undergoing elective thyroid surgery with intraoperative neuromonitoring and low-dose muscle relaxants. Intubation was faster with VRL: mean time was 33.27 ± 8.36 s versus 52.19 ± 9.83 s with Macintosh (P < 0.001). VRL was also associated with lower mean arterial pressure at intubation and a smaller increase in pressure. Intubation success, heart rate, oxygen saturation, laryngoscopic view, and intubation-related complications did not differ significantly between groups.
Key findings
- Mean intubation time was 33.27 ± 8.36 s with VRL versus 52.19 ± 9.83 s with Macintosh (P < 0.001).
- Mean arterial pressure at intubation and its increase during intubation were lower with VRL than with Macintosh (P < 0.005).
- Intubation success, heart rate, oxygen saturation, laryngoscopic view, and intubation-related complications showed no significant between-group differences (P > 0.05).
Why it matters
Intubation for thyroid surgery with intraoperative neuromonitoring uses a low-dose relaxant protocol, making the choice of airway device relevant to both procedural efficiency and peri-intubation haemodynamics. In this trial, VRL shortened intubation time and was associated with a smaller blood-pressure response, while measured success and complication outcomes were similar.
What to keep in mind
The trial was conducted at a single centre, and intubations were performed by two experienced anesthesiologists; the findings may not generalize to other settings or operators.