Comparison of GlideScope video laryngoscope with Macintosh laryngoscope in adult patients undergoing elective surgical procedures

Abstract

Background:GlideScope (GS) is a video laryngoscope that allows a real-time view of the glottis and endotracheal intubation. It provides a better view of the larynx without the need for alignment of the airway axes.Aim:This prospective randomized comparative study is designed to compare the intubation time, hemodynamic response, and complications associated with intubation using a GS or Macintosh laryngoscope (ML) in adult subjects undergoing elective surgical procedures.Materials and Methods:Sixty American Society of Anesthesiologists physical status 1–2 patients were included in this prospective randomized comparative study. Patients were randomized to be intubated using either a GS or an ML. The primary outcome measure was the intubation time. The secondary outcome measures were the hemodynamic response to intubation and the incidence of mucosal injury.Statistical Analysis:Mean and standard deviation were calculated for different parameters under the study. The observed results were analyzed using Student's t-test for quantitative data and Z-test of proportions. P<0.05 was considered statistically significant.Results:Intubation time was longer in GS group (45.7033 ± 11.649 s) as compared to ML (27.773 ± 5.122 s) P< 0.0001 with 95% confidence interval (95% CI) −13.2794 to −22.5806. GS provided better Cormack and Lehane laryngoscopic view (P = 0.0016 for grade 1 view) with 95% CI −0.1389 to −0.5951. GS group exhibited more laryngoscopic response than ML group with more increase in blood pressure and heart rate, but the difference was not statistically significant. More cases of mucosal trauma were documented in GS group.Conclusion:Use of GS to facilitate intubation led to better glottic view but took a longer time to achieve endotracheal intubation. GS was associated with more hemodynamic response to intubation and mucosal injury in comparison with an ML.

A new retrograde transillumination technique for videolaryngoscopic tracheal intubation

“…Videolaryngoscopy is now established in routine anaesthetic practice and recommended as a first‐ or second‐line alternative technique in the case of expected difficult airway situations . However, videolaryngoscopy has certain limitations, in particular, in the hands of less experienced users .…”

Comparison of Hemodynamic Response to Orotracheal Intubation with Conventional Laryngoscope versus Fiberoptic Bronchoscope

“…These responses can be attenuated by different 14 group of drugs e.g dexmedetomidine and fentanyl. During the fiberoptic intubation, the insertion cord must be placed into the trachea for guidance followed by advancing the tracheal tube over the insertion cord into the trachea and then the FOB is 15 removed. This can cause repeated friction and 16,17 irritation to the trachea.…”

Should the Glidescope video laryngoscope be used first line for all oral intubations or only in those with a difficult airway? A review of current literature

“…Aqil et al (2016) highlighted that a good view of the glottis is essential for successful intubation. Parasa et al (2016) and Thong and Goh (2013) argued that a grade 1 or 2 CL view using the GVL does not guarantee first attempt intubation success. Healy et al (2012) and Voelckel (2013) supported this finding by stating that a good view of the glottis does not guarantee a successful intubation on first attempt and often it is down to operator experience with the laryngoscope that contributes to success.…”

“…All studies began timing from the moment the laryngoscope passed the lips. The difference occurred at the end point: three studies classified successful intubation stopped timing once C0 2 was recorded on the monitor via the capnography (Aqil et al 2016, Ayoub et al 2010, Parasa et al 2016). However, one study stopped the timing at the point where the first successful forced inspiration was achieved (Platts-Mills 2009).…”