Effect of jaw thrust and cricoid pressure maneuvers on glottic visualization during GlideScope videolaryngoscopy

Abstract

The jaw thrust maneuver was superior to videolaryngoscopy alone in improving the modified C&L grade and the visualized glottic area; however, no significant improvement was noted with cricoid pressure. We therefore recommend the use of jaw thrust as a first-line maneuver to aid in glottic visualization and tracheal intubation during GlideScope videolaryngoscopy.

Effect of Cricoid Pressure on Laryngeal View During Macintosh, McGrath MAC X-Blade and GlideScope Video Laryngoscopies

“…Corda et al (11) showed that there was no statistically significant difference in glottis grade (39% of glottis grade improved and 20% worsened) when using GlideScope under cricoid pressure in 100 patients. However, it significantly decreased the glottis area by forcing vocal cord apposition.…”

“…From data by Corda et al (11) and to detect a 20% worsened Cormack-Lehane grade and a 90% power with a=0.05, we calculated our sample size to be 29 per group (a total of 87 for the three groups). Then, we decided to enrol 40 patients per group (a total of 120) with consideration of possible exclusions.…”

Effect of Jaw Thrust and BURP Maneuvers on Glottis Visualization During C-MAC® Videolaryngoscopy

“…Several measures are suggested as predictors of difficult airway namely short TMD, limited mouth opening, and head extension (15)(16)(17)(18). Expectedly, the current study patients with these predictors got higher Cormack-Lehane scores.…”

Comparison of hemodynamic responses to endotracheal intubation with the GlideScope video laryngoscope and Macintosh laryngoscope in patients undergoing cardiovascular surgery

“…Finally, a pre-curved specific stylet compatible with the 60º curve of GlideScope blade must be used and both advancement of tracheal tube and withdrawal of the stylet after intubation may cause a stimuli to the anterior commissure or anterior wall of trachea. [31] Xue et al [20] studied the GlideScope and Macintosh laryngoscopes in ASA I patients and did not found significant advantage in terms of hemodynamic response to endotracheal intubation, while intubation time was significantly higher in the GlideScope group. They claimed that the manipulation of GlideScope stylet, may cause higher stimulus to the larynx and trachea, counterbalancing the lower upward lifting force required for laryngoscopy.…”