A comparison between the GlideScope^® Video Laryngoscope and direct laryngoscope in paediatric patients with difficult airways – a pilot study

Abstract

Summary The GlideScope® Video Laryngoscope may improve the view seen at laryngoscopy in adults who have a difficult airway. Manikin studies and case reports suggest it may also be useful in children, although prospective studies are limited in number. We hypothesised that the paediatric GlideScope will result in an improved view seen at laryngoscopy in children with a known difficult airway, compared to direct laryngoscopy. Eighteen children with a history of difficult or failed intubation were prospectively recruited. After inhalational induction, each patient had laryngoscopy performed using a standard blade followed by GlideScope videolaryngoscopy. The GlideScope yielded a significantly improved laryngoscopic view, both with (p = 0.003) and without (p = 0.004) laryngeal pressure. The mean (SD) time taken to achieve the optimal view was 20 (8)s using conventional laryngoscopy and 26 (22)s using the GlideScope® (p = 0.5). The GlideScope® significantly improves the laryngoscopic view obtained in children with a difficult airway.

Orotracheal intubation of morbidly obese patients, comparison of GlideScope® video laryngoscope and the LMA CTrach™ with direct laryngoscopy

“…Also in a study including children who are known to have a difficult airway, the use of the GlideScope videolaryngoscope, with and without laryngeal pressure, significantly improves the Cormack and Lehane grade at laryngoscopy. [11] In this study, the tracheal intubation time was significantly shorter with the Glide Scope ® video laryngoscope (GVL) than with the Macintosh laryngoscope and the LMA CTrach™. In our study significantly more maneuvers (Laryngeal mask manipulation) were applied for the satisfactory ventilation and viewing of the glottis with the LMA CTrach™ (30%) versus 0% for GVL and DL ( P < 0.05) and this explain the longer time for intubation with LMA CTrach™ and improved overall success rate.…”

Clamp to prevent collapse

“…We agree with the authors' view that the BURP manoeuvre (backward, upward and right-sided pressure on the larynx) provides better glottic exposure using the paediatric GlideScope. Overall, the paediatric GlideScope, with or without the BURP manoeuvre, provided a better glottic view than the Macintosh laryngoscope in the same study [1]. However, in 6 of their 18 children, the paediatric GlideScope without the BURP manoeuvre provided a view of the glottis that was equal to or worse than that by the Macintosh laryngoscope without the BURP manoeuvre (Cormack-Lehane grade 3 and 4).…”

“…We read with interest the article by Karsli et al [1], which demonstrated the usefulness of the paediatric GlideScope Ò video laryngoscope (Verathon Medical Inc., Bothell, WA, USA) in children with a difficult airway, relative to conventional direct laryngoscopy using the Macintosh blade. We agree with the authors' view that the BURP manoeuvre (backward, upward and right-sided pressure on the larynx) provides better glottic exposure using the paediatric GlideScope.…”

“…This report is relevant for anaesthetists performing fibreoptic laryngoscopy and tracheal tube placement through a LMA [4,5] Anaesthesia ................................................................................................................................................................................................................... to 44% in elderly patients [1]. This is a multifactorial process of which one potentially preventable component is lung derecruitment.…”

“…Flexible endoscopy was planned via a laryngeal mask airway (LMA) as part of a modified sleep endoscopy protocol [1] to detect any stenoses of the subglottis and trachea. Anaesthesia was induced with sevoflurane 8% in 50% oxygen and air and a size 4 LMA (LMA classic Ò ; Intavent Orthofix Ltd., Berkshire, UK) inserted and inflated with 30 ml air.…”