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A comparison of glidescope videolaryngoscope with Macintosh laryngoscope for laryngeal views

Journal of Medical Colleges of PLA(China) 2007年第1期22卷 54-58页

作者：李金宝王晓琳熊源长范晓华刘毅许华马宇杜健儿翟蓉邓小明 Department of Anesthesiology Changhai HospitalSecond Military Medical UniversityShanghai 200433China

Objective：To describe the use of the glidescope in comparison with direct laryngoscopy for elective surgical patients requiring tracheal intubation. Methods：Two hundred patients, ASA Ⅰ - Ⅱ scheduled for elective surgery under general anesthesia requiring orotracheal intubation were selected. Information was collected identifying the patient demographics and airway assessment features （Mallampati oropharyngeal scale, thyromenta distance and mouth opening）. In a random crossover design, after induction of anesthesia and neuromuscular block, the laryngoscopes were inserted in turn, and the views of the glottis at laryngoscopy （Cormack and Lehane scores） were compared. The tracchea was intubated using either the standard Macintosh laryngoscope or glidescope after the second grading at laryngoscopy was done. Complications associated with intubating were recorded. Results： There were 200 patients including 107 males and 93 females, with mean age being 52±13 years, height 164.8±11.3 cm, weight 64.0±11. 5 kg, thyromental distance 6. 9± 1.1 cm, and mouth opening 5.7±0.5 cm. There was a significant association between the preoperative view of the oropharynx （Mallampati score） and the view of the glottis at laryngoscopy for both the direct Macintosh laryngoscope （P〈0. 001） and the glidescope （P〈0. 001）. Among 200 patients, 106 patients had the same C＆L grade, 91 of remaining patients showed improvement in the C＆L grade （P〈0. 001 ） obtained with glidescope compared with the direct Macintosh laryngoscope. 3 of remaining patients showed better view of the glottis（C＆L grade） with the direct Macintosh laryngoscope （grade 1） than with glidescope （grade 2）. There were no cases of failure to be intubated. There were no cases of dental or mucosal injury in all patients. Conclusion： glidescope videolaryngoscope yielded comparable or superior laryngeal view compared with Macintosh laryngoscope. The new type of laryngoscope may have potential advantages for managing the difficult airway.

关键词： anesthetic techniques, laryngoscopy equipment, glidescope videolaryngoscope equipment, Macintosh laryngoscope intubation, tracheal

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