Visual rigid laryngoscope versus Macintosh laryngoscope using low-dose relaxants in thyroid surgery
- 1Department of Anesthesiology, Anesthesiology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- 2The First School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China
- 3Department of Anesthesiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
Abstract
Objective: This study evaluated the safety and efficacy of the Macintosh laryngoscope versus the visual rigid laryngoscope (VRL) for tracheal intubation under a low-dose muscle relaxant protocol in thyroid surgery, to provide clinical evidence for the selection of optimal intubation tools for this setting.
Methods: In this single-center, randomized controlled trial, two experienced anesthesiologists performed tracheal intubation using either the Macintosh laryngoscope (Mac group, n = 47) or VRL (VRL group, n = 45) in patients undergoing elective thyroid surgery with Intraoperative neuromonitoring (IONM). The primary outcome was intubation time. Secondary outcomes included first-attempt intubation success rate, hemodynamic changes during the peri-intubation period, laryngoscopic view graded by the Cormack-Lehane classification, and intubation-related complications.
Results: The intubation time was significantly shorter in the VRL group (mean ± SD, 33.27 ± 8.36 s) than in the Mac group (52.19 ± 9.83 s) ( P < 0.001). The intubation success rate and heart rates did not differ between groups ( P > 0.05). The mean arterial pressure (MAP) at intubation and the amplitude of MAP increase during intubation was lower in Group VRL than in Group Mac ( P < 0.005). No statistically significant differences were observed between the two groups in peripheral oxygen saturation (SpO ₂ ), Cormack-Lehane classification, or intubation-related complications ( P > 0.05).
Conclusion: For thyroid surgery using a low-dose muscle relaxant protocol to enable IONM, the VRL provides significantly shorter intubation time and better hemodynamic stability at intubation compared with the Macintosh laryngoscope. No significant differences were observed between the two devices in intubation success rate, laryngoscopic view, or intubation-related complications.
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BibTeX
@article{qiu2026visual,
title = {{Visual rigid laryngoscope versus Macintosh laryngoscope using low-dose relaxants in thyroid surgery}},
author = {Weihuang Qiu and Tingjie Wang and Lijun Weng and Menglu Shi and Cailing Guo and Binmei Yu and Xianzhong Lin and Bo Lin and Youguang Gao},
journal = {PeerJ},
year = {2026},
month = oct,
doi = {10.7717/peerj.21893},
url = {https://peerj.com/articles/21893},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Visual rigid laryngoscope versus Macintosh laryngoscope using low-dose relaxants in thyroid surgery
AU - Weihuang Qiu
AU - Tingjie Wang
AU - Lijun Weng
AU - Menglu Shi
AU - Cailing Guo
AU - Binmei Yu
AU - Xianzhong Lin
AU - Bo Lin
AU - Youguang Gao
PY - 2026
DA - 2026/10/01
JO - PeerJ
DO - 10.7717/peerj.21893
UR - https://peerj.com/articles/21893
AB - Objective: This study evaluated the safety and efficacy of the Macintosh laryngoscope versus the visual rigid laryngoscope (VRL) for tracheal intubation under a low-dose muscle relaxant protocol in thyroid surgery, to provide clinical evidence for the selection of optimal intubation tools for this setting. Methods: In this single-center, randomized controlled trial, two experienced anesthesiologists performed tracheal intubation using either the Macintosh laryngoscope (Mac group, n = 47) or VRL (VRL group, n = 45) in patients undergoing elective thyroid surgery with Intraoperative neuromonitoring (IONM). The primary outcome was intubation time. Secondary outcomes included first-attempt intubation success rate, hemodynamic changes during the peri-intubation period, laryngoscopic view graded by the Cormack-Lehane classification, and intubation-related complications. Results: The intubation time was significantly shorter in the VRL group (mean ± SD, 33.27 ± 8.36 s) than in the Mac group (52.19 ± 9.83 s) ( P < 0.001). The intubation success rate and heart rates did not differ between groups ( P > 0.05). The mean arterial pressure (MAP) at intubation and the amplitude of MAP increase during intubation was lower in Group VRL than in Group Mac ( P < 0.005). No statistically significant differences were observed between the two groups in peripheral oxygen saturation (SpO ₂ ), Cormack-Lehane classification, or intubation-related complications ( P > 0.05). Conclusion: For thyroid surgery using a low-dose muscle relaxant protocol to enable IONM, the VRL provides significantly shorter intubation time and better hemodynamic stability at intubation compared with the Macintosh laryngoscope. No significant differences were observed between the two devices in intubation success rate, laryngoscopic view, or intubation-related complications.
SN - 2167-8359
ER -