Nasotracheal intubation with MacGrath videolaryngoscope using Schroeder directional stylet: Case series

BACKGROUND AND AIMS: MacGrath videolaryngoscope is one of the recent videolaryngoscopes, which can be used to facilitate nasotracheal intubations using Scroeder directional stylet. MATERIAL AND METHODS: 15 patients, American Society of Anesthesiologists Grades I-II, undergoing tonsillectomy, requiring nasotracheal intubation were included. All patients were intubated with MacGrath videolaryngoscope and Schroeder stylet. Primary outcome measures were duration and ease of intubation. Overall success rate, number of attempts, modified Cormack-Lehane (C-L) grading, and complications were also recorded. RESULTS: All 15 intubations were successful during first laryngoscopy attempt. C-L Grade I views were obtained in 14 patients (93%) and Grade II view in one patient (7%). The time required to obtain the best C-L view was 9.4 ± 1.5 s. The time taken to complete tracheal intubation was 34.27 ± 3.38 s. Average numerical rating scale for tracheal intubation was 8.7 ± 0.9. Minor complications occurred in four patients (26.7%). CONCLUSIONS: MacGrath videolaryngoscope produces excellent laryngoscopic views in patients with normal airways. Impaction of tracheal tube on posterior nasopharyngeal wall can be overcome by Schroeder stylet.