A comparison of the Glidescope®, Pentax AWS®, and Macintosh laryngoscopes when used by novice personnel: a manikin study

Malik, Muhammad Anwar; Hassett, Patrick; Carney, John; Higgins, Brendan D.; Harte, B. H.; Laffey, John G.

doi:10.1007/s12630-009-9165-z

Cited by 60 publications

(62 citation statements)

References 31 publications

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“…In addition, the number of maneuvers needed for intubation was higher compared to the C-MAC by the D-Blade. Therefore, a good quality of view does not always result in a successful tracheal intubation (14,28). Ng et al (23), in a study of adult patients with potentially difficult airways, demonstrated that the C-MAC allowed more rapid intubation times with fewer intubation attempts, although more grade 1 laryngoscopic views are obtained by McGrath video laryngoscopes.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult Airways

Kılıçaslan¹,

Topal²,

Erol³

et al. 2014

Turk J Anesth Reanim

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Objective: Recently, to further enhance the potential in the management of difficult airways, the highly angulated D-Blade was added to the C-MAC system. The purpose of this study was to investigate the laryngoscopic view and intubation parameters using the new C-MAC D-Blade in comparison to the conventional C-MAC video laryngoscope and Macintosh direct laryngoscope in simulated easy and difficult airways. Methods:We recruited 26 experienced anaesthesia providers into a randomized trial. Each performed tracheal intubation of a Laerdal SimMan ® manikin with each laryngoscope in the following laryngoscopy scenarios: (1) normal airway, (2) cervical spine immobilization, and (3) tongue edema. The intubation times, success rates, number of intubation attempts, laryngoscopic views, and severity of dental compression were recorded. Results:In all scenarios, video laryngoscopes provided better laryngeal exposure than the ML and appeared to produce less dental pressure. In the cervical spine immobilization scenario, D-Blade caused less dental pressure and showed better Cormack-Lehane (CL) classes than the other devices (p<0.001). There were no differences between video laryngoscopes in success of tracheal intubation (p>0.05). The CMAC provided the most rapid intubation. The rate of failure was 19% with ML. In the tongue edema scenario, the CMAC provided the most rapid and successful intubation (p<0.001). There were no differences between video laryngoscopes in laryngoscopic views according to CL classification and dental pressure (p>0.05). The rate of failure was 46% with the ML and 7% with the D-Blade. Conclusion:The CMAC D-Blade caused less dental pressure than the conventional C-MAC and ML in the cervical immobilization scenario. The conventional CMAC performed better than the D-Blade and ML in the tongue edema scenario. These two video laryngoscopes may complement each other in various difficult airway situations.

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Section: Discussionmentioning

confidence: 99%

Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult Airways

Kılıçaslan¹,

Topal²,

Erol³

et al. 2014

Turk J Anesth Reanim

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“…Many such devices now exist on the market, including the Glidescope [13,23], Airtraq [14], Pentax AWS [12,15,16], TruView [12,16] and LMA C-Trach [17]. The lack of a gold standard descriptor for intubation difficulty has hampered investigations into the clinical utility of these devices.…”

Section: Discussionmentioning

confidence: 99%

Determination of the utility of the Intubation Difficulty Scale for use with indirect laryngoscopes

McElwain¹,

Simpkin

Laffey³

2011

Anaesthesia

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SummaryThe purpose of this study was to determine whether the Intubation Difficulty Scale is meaningful when used with indirect laryngoscopes. Data were analysed from previously published clinical trials from our group that compared the indirect laryngoscopes with the Macintosh laryngoscope. For each laryngoscope type, the Intubation Difficulty Scale score obtained for each tracheal intubation was correlated with data for duration of the intubation attempt and with the user rated difficulty of the intubation attempt. The strengths of the correlations between these indices were then compared for tracheas intubated with the Macintosh vs the indirect laryngoscopes. The Intubation Difficulty Scale performed well when compared with data for duration and user rated difficulty of the intubation attempts for the both direct and indirect laryngoscopy. However, the correlation between the Intubation Difficulty Scale score and both user rated difficulty (p = 0.001) and the duration of tracheal intubation (p = 0.003) were significantly stronger for the Macintosh laryngoscope compared with the indirect laryngoscopes. In contrast, the correlation between user rated difficulty scores and the data for duration of tracheal intubation was not different between the device types. The Intubation Difficulty Scale performs less well with indirect laryngoscopes than with the Macintosh laryngoscope. These findings suggest the need for caution with the use of this score with indirect laryngoscopes. Difficult tracheal intubation remains a major source of morbidity and mortality, in the operating theatre [1][2][3] and in the emergency setting [4,5]. Difficult or failed tracheal intubation is an important cause of anaesthetic death and brain damage [6][7][8][9][10][11]. These issues have stimulated the development of 'indirect' laryngoscopes, with the aim of reducing the difficulty obtaining a laryngeal view. Many such devices now exist on the market, including the Glidescope [12, 13], Airtraq [14], Pentax Airway Scope (AWS) [12,15,16], TruView [12,16], and LMA C-Trach [17]. One difficulty encountered investigating the utility of these devices is the lack of a gold standard descriptor for intubation difficulty. While indices such as the duration of tracheal intubation attempts and user rated scores of the difficulty of laryngoscopy and intubation are useful, they do not provide a complete picture. A more objective scoring system might serve as a reproducible quantitative means of overcoming some of these limitations.Adnet et al. proposed the Intubation Difficulty Scale (IDS), which incorporates seven parameters (see Appendix 1) [18], for use when describing direct laryngoscopy and intubation. More recently, the IDS has been used to describe difficulty of laryngoscopy and tracheal intubation with indirect laryngoscopes in multiple studies by our group [13,16,17] and others [15,19]. However, the validity of the IDS when used with indirect laryngoscopes has not been evaluated.

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“…Since the introduction of the GlideScope ® into clinical practice, it was compared with the Macintosh laryngoscope in several studies [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. In most studies the participants did not have experience with the GlideScope ® [2][3][4][5][6][11][12][13][14] and in some of the more recent studies the participants did not even have experience with direct laryngoscopy (medical students) [12,14].…”

Section: Discussionmentioning

confidence: 99%

“…In most studies the participants did not have experience with the GlideScope ® [2][3][4][5][6][11][12][13][14] and in some of the more recent studies the participants did not even have experience with direct laryngoscopy (medical students) [12,14]. Only three studies used exclusively participants with GS and Macintosh experience [7,8,17].…”

Section: Discussionmentioning

confidence: 99%

The GlideScope<sup>®</sup> Video Laryngoscope and the Macintosh Laryngoscope Compared in a Simulated Difficult Airway with Immobilization and Bleeding—A Randomized, Prospective, Crossover Study

Ackermann¹,

Pott²,

Vaida³

et al. 2012

OJAnes

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Background: This study assesses the effectiveness of the GlideScope ® Videolaryngoscope (GS) in comparison with the Macintosh laryngoscope in a simulated difficult airway with blood in the airway and restricted range of motion of the neck. 39 participants experienced with the GS and the Macintosh laryngoscope were used. Methods: This analysis is a prospective, randomized, crossover study. Our study was performed on an intubation simulation model with artificial blood in the airway and restricted range of motion. The intubation time was recorded from picking up the laryngoscope to advancing the endotracheal tube through the glottic opening. Secondary endpoints were the Cormack & Lehane score, the percentage of the glottis seen, the subjective difficulty of the procedure on a scale of 0 to 10, the number of adjustment maneuvers, the number of attempts, and the number of failed intubations. Attempts were defined as removal of instruments from the airway and reinsertion. Failed intubations were defined as esophageal intubations or intubations lasting longer than 120 seconds. Results: The mean intubation time was 47.6 seconds with the GS and 21.4 seconds with the Macintosh laryngoscope. There were 3 failed intubations with the Macintosh laryngoscope and 4 failed intubations with the GS. The failed intubations with the Macintosh laryngoscope were all esophageal intubations. The failed intubations with the GS were due to exceeding the time limit of 120 seconds. Both devices had a mean Cormack & Lehane score of 1.8 and the mean percentage of the Glottis seen was 58% for both devices. The average subjective difficulty on a scale from 0 to 10 was ranked 4.16 for the Macintosh and 5.14 for the GS. Participants needed an average of 1 adjustment maneuvers with the Macintosh laryngoscope and 2.7 adjustments with the GS. Conclusion: The GS, used by experienced anesthesiologists in a simulated difficult airway, had an inferior performance compared to the Macintosh laryngoscope in terms of intubation time, number of intubation attempts, number of adjustment maneuvers, and number of failed intubations.

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A comparison of the Glidescope®, Pentax AWS®, and Macintosh laryngoscopes when used by novice personnel: a manikin study

Cited by 60 publications

References 31 publications

Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult Airways

Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult Airways

Determination of the utility of the Intubation Difficulty Scale for use with indirect laryngoscopes

The GlideScope<sup>®</sup> Video Laryngoscope and the Macintosh Laryngoscope Compared in a Simulated Difficult Airway with Immobilization and Bleeding—A Randomized, Prospective, Crossover Study

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A comparison of the Glidescope®, Pentax AWS®, and Macintosh laryngoscopes when used by novice personnel: a manikin study

Cited by 60 publications

References 31 publications

Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult Airways

Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult Airways

Determination of the utility of the Intubation Difficulty Scale for use with indirect laryngoscopes

The GlideScope&lt;sup&gt;&#174;&lt;/sup&gt; Video Laryngoscope and the Macintosh Laryngoscope Compared in a Simulated Difficult Airway with Immobilization and Bleeding—A Randomized, Prospective, Crossover Study

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The GlideScope<sup>®</sup> Video Laryngoscope and the Macintosh Laryngoscope Compared in a Simulated Difficult Airway with Immobilization and Bleeding—A Randomized, Prospective, Crossover Study