A randomised controlled trial comparing the GlideScope^® and the Macintosh laryngoscope for double‐lumen endobronchial intubation

Abstract

SummaryDouble-lumen endobronchial tubes are the most common method of achieving lung isolation and one-lung ventilation during thoracic anaesthesia and surgery. We compared the clinical performance of the Macintosh laryngoscope and the GlideScope â during endobronchial intubation with a double-lumen tube. Seventy patients with no predictors for difficult laryngoscopy were allocated randomly to the Macintosh laryngoscope or GlideScope. There was no statistical difference in the rate of success at the first attempt (91% vs 83%, respectively). On a numerical rating scale (scored from 0 to 10), the 30 anaesthetists who took part in the study rated endobronchial intubation overall as easier using the Macintosh compared with the GlideScope, 2 (1-3 [0-8]) vs 3 (2-6 [0-10]), respectively, p = 0.003. Postoperative voice changes were also less common in the Macintosh group (8 (22%) vs 17 (58%), p = 0.045). Anaesthetists found the GlideScope more difficult to use than the Macintosh laryngoscope and endobronchial intubation took longer; therefore, we cannot recommend its routine use with double-lumen tubes in patients who are predicted to have a normal airway.

Use of the Macintosh laryngoscope for double‐lumen tracheal tube placement

“…'s findings are similar to those of Russell et al. , who showed that the GlideScope ® videolaryngoscope was more difficult to use when placing a double‐lumen tube, particularly for novices. As the authors state, experience with the McGrath videolaryngoscope for standard tracheal intubation is important for successful double‐lumen placement.…”

A comparison of the McGrath®Series 5 videolaryngoscope and Macintosh laryngoscope for double-lumen tracheal tube placement in patients with a good glottic view at direct laryngoscopy

“…In a randomised controlled trial of the GlideScope and Macintosh laryngoscope for double‐lumen tube placement in 70 patients with anticipated normal airways, Russell et al. found that it was more difficult to use the GlideScope, particularly for novices . Similarly Wasem et al.…”

Comparison of McGRATH MAC and Macintosh laryngoscopes for double-lumen endotracheal tube intubation by anesthesia residents: a prospective randomized clinical trial

“…One retrospective study demonstrated that videolaryngoscopes are superior to the McL for DLT intubation [16]. Surprisingly, one prospective analysis suggested that intubation with the GlideScope may make the placement of DLTs more difficult than with the McL [17], particularly for novices, suggesting the inherent difficulty of using videolaryngoscopes for DLT intubation.…”