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Bridalveil Falls - photo by JoAnn Sturman
Scott Sturman, M.D.
Free standing surgery centers face cost challenges when weighing the need to acquire new technology. The McGrath MAC fiberoptic laryngoscope is an less expensive alternative for operating venues where patients are healthier, and LMA anesthesia is the overwhelming choice for general anesthesia.
The current product is superior to the older Series 5. At a cost of $3400 and compatible with MAC 2, 3, and 4 blades, the same system can be used for both adult and children. The disposable plastic MAC blade slips on and off the fiberoptic light source quite easily and costs $10 apiece. It is powered by a 6V lithium battery which lasts for 250 minutes. Contrast this with the $11,000 Glide Scope which requires an additional $5000 attachment for pediatric patients and utilizes the cumbersome $14 disposable GVL sleeve, and the playing field becomes more level.
The video screen for the Covidien is mounted on the blade, so it is in line with the intubation target. Its girth is also much smaller than the Glide Scope with the disposable sleeve, so an ETT has more room in the oropharynx for maneuvering. In these two respects the product has a distinct advantage.
I tried three laryngoscopies last week with the McGrath product, and the view was acceptable, although it seemed the field of vision and the light intensity were less than the Glide Scope. However, one of the patients had a difficult airway, and the view of the cords was excellent.
The appropriate intubating apparatus for difficult airways may differ between anesthesia departments, but with surgery centers facing intense economic pressures and needing to address patient safety issues, their is no harm in trialling the McGrath MAC fiberoptic.
