A Non-Inferiority Study of the Speed and Success of Nasotracheal Intubation in Maxillofacial Surgeries Using Macintosh Direct Laryngoscope versus Sanyar® Video Laryngoscope

Abstract

Background: The recently developed blade design of the Sanyar® video laryngoscope yields an exceptionally precise visualization of the larynx, thereby easing the process of tracheal intubation. Objectives: A non-inferiority clinical investigation, to assess the efficacy of the Sanyar® as compared to the Macintosh® direct laryngoscope for nasotracheal intubation in the context of maxillofacial surgeries. Methods: 78 patients for maxillofacial surgery were divided randomly into two groups and intubated through the nose using either the Sanyar® or Macintosh® laryngoscope after anesthesia was induced. The study measured intubation time and secondary objectives included success rate, attempts, and hemodynamic changes in two groups. Results: 40 eligible patients in the Sanyar® and 38 in the Macintosh® group were involved. Of all, 42(53.8%) were men and 36(46.2%) were women. The average age of patients in the Sanyar® and Mackintosh groups was (31.62±13.41) and (30.81±10.89), respectively. 39(98%) of the Sanyar® group and 33(86%) of the Macintosh® group had successful laryngoscopy and intubation, with a P-value<0.034. Sanyar® group had a significantly shorter intubation time than Macintosh® (P-value<0.001). Hemodynamic changes before and after laryngoscopy and intubation had no significant differences between the two groups. Conclusion: The Sanyar® video laryngoscope reduced the time of nasal tracheal intubation in maxillofacial surgery compared to direct laryngoscopy and improved the success rate of the first intubation attempt.