• Mauricio Luiz Malito, MathiasLigia Andrade da Silva TellesLADSTSanta Casa de São Paulo, Faculdade de Ciências Médicas, São Paulo, SP, Brazil; Promatre Paulista, Serviço de Anestesia, São Paulo, SP, Brazil., Aldemar Kimura Junior, Guilherme Haelvoet Correa, and Vitor Ramalho Bardauil.
• CET/SBA da Santa Casa de São Paulo, São Paulo, SP, Brazil; Hospital AACD, CTVA (Centro de Treinamento em Vias Aéreas), São Paulo, SP, Brazil. Electronic address: mmalito@uol.com.br.
• Braz J Anesthesiol. 2021 Apr 3.

IntroductionAdequate and continuous airway management by health professionals is fundamental to ensure patient safety and protection. Among several techniques, laryngoscopy for orotracheal intubation is considered a basic skill, so it is taught and learned in medical school and used during the future years of professional practice. However, in some clinical scenarios, physical and anatomical characteristics can make laryngoscopy exceedingly difficult. In the last decade, some new devices have emerged to apply indirect or video-assisted imaging systems, so-called videolaryngoscopes. They have shown great efficiency in difficult intubation cases and have improved teaching and training. Our study introduced a videolaryngoscope, the McGrath™ MAC, in the regular laryngoscopy training rotation for 3rd-year undergraduate medical students and evaluated whether there was any associated optimization of the students' performance.MethodStudents from two different classes and years (2017 and 2018) were randomly divided into two groups and received theoretical and practical training in the techniques of Direct Laryngoscopy (DL) and Videolaryngoscopy (VL). The students in each group applied the manoeuvres and simulated three tracheal intubation attempts on mannequins. They were evaluated for their success rate on the first attempt, the time required to finalize the intubation, and the visualization of the glottic structures according to the classification of Cormack-Lehane (C&L).ResultsTwo hundred and four students with an average age of 21 ± 2 years participated in the study; the groups were similar. There was a significant difference between the VL and DL groups in the 1st attempt success rate (97% and 89.4%, respectively, p = 0.0497 - 95% CI), but such a difference was not seen for the other attempts or regarding the number of oesophageal intubations (3% and 7.7%). The students in the VL group were faster than those in the DL group in all intubation attempts; in parallel, the vast majority of the VL group reported excellent visualization conditions, with 75% of the attempts classified as Cormack-Lehane grade 1.ConclusionThe introduction of a videolaryngoscope in medical students' training improved the visualization of anatomical structures and allowed tracheal intubation maneuvers to be performed faster and with a higher success rate on the first attempt. Thus, under the conditions of this prospective study, the videolaryngoscope had a positive impact on training and proved to be a promising tool for teaching laryngoscopy.Copyright © 2021 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

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