Comparison Of Glidescope Research Articles

An approach to difficult airway in infants: Comparison of GlideScope® Spectrum LoPro, GlideScope® Spectrum Miller and conventional Macintosh and Miller blades in a simulated Pierre Robin sequence performed by 90 anesthesiologists.

Airway management can be challenging in neonates and infants. The Pierre Robin sequence (PRS) is a condition characterized by micrognathia, glossoptosis and airway obstruction. The airway management of these patients poses great challenges for anesthesiologists and pediatricians alike. To date, there has been no direct comparison of the hyperangulated GlideScope® Spectrum LoPro (GLP), the straight GlideScope® Spectrum Miller (GSM), a conventional Macintosh (MC) and a conventional Miller blade (ML) in patients with PRS. For this purpose, 90 anesthesiologists (43 with limited experience, 47 with extensive experience) performed orotracheal intubation on an Air-Sim® Pierre Robin X manikin using GLP, GSM, MC and ML in randomized order. 'Time-to-vocal-cords', 'time-to-intubate', 'time-to-ventilate', the severity of oral-soft-tissue-trauma and the subjective evaluation of each device were recorded. A significantly faster and better view of the vocal cords and lower oral-soft-tissue-trauma was achieved using the GLP (p<0.001). Though, there were no significant differences in the 'time-to-intubate' or 'time-to-ventilate'. The highest intubation success rate was found with GSM and the lowest with GLP (GSM 100%, ML 97.8%, MC 96.7%, GLP 93.3%). When using the videolaryngoscopes, there were no undetected esophageal intubations but in six cases prolonged attempts of intubation (>120s) with the GLP. In the sub-group with extensive experience, we found significantly shorter intubation times for the GSM and ML. The GLP was the tool of choice for most participants, while the conventional MC received the lowest rating. Videolaryngoscopy leads to increased safety for the prevention of undetected esophageal intubation in the airway management in a PRS manikin. Hyperangulated blades may ensure a good and fast view of the vocal cords and low oral-soft-tissue-trauma but pose a challenge during the placement of the tube. Specific skills and handling seem to be necessary to ensure a safe tube placement with this sort of blades.

Comparison of GlideScope\u2122 visualization and neck flexion with lateral neck pressure nasogastric tube insertion techniques in anesthetized patients: a randomized clinical study

ObjectiveNasogastric tube (NGT) insertion in anesthetized and intubated patients can be challenging, even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between GlideScope™ visualization and neck flexion, with lateral neck pressure techniques.Material and methodsThis randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery, under relaxant general anesthesia, who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope™ group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of the first and second attempts, duration of insertion, and complications were recorded.ResultsThe total success rate was 79.1% in group G, compared with 76.7% in group F (P = 1). The median time required for NGT insertion was significantly longer in group G, for both first and second attempts (97 vs 42 s P < 0.001) and (70 vs 48.5 s P = 0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications for both techniques.ConclusionUsing GlideScope™ visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique, in the degree of success rates of insertion. Although complications were not statistically significant between groups, neck flexion with lateral neck pressure technique was significantly less time-consuming for both first and second attempts.Trial registrationRetrospectively registered: Thai Clinical Trial Registry (TCTR)20171229003. Registered on 19 December 2017

Intubation of a Paediatric Manikin in Tongue Oedema and Face-to-Face Simulations by Novice Personnel: a Comparison of Glidescope, Airtraq and Direct Laryngoscopy

Glidescope and Airtraq were designed for facilitating intubation and for teaching regarding the airway anatomy. We aimed to evaluate their efficacy in normal airway, tongue oedema and face-to-face orotracheal intubation models when used by novice personnel. After the local human research ethics committee approval, 36 medical students who were in the beginning of their third year were enrolled in this study. After watching a video regarding intubation using one of these devices, the students intubated a paediatric manikin with a Glidescope or Airtraq via the normal airway, tongue oedema and face-to-face approach. Although the insertion and intubation times were similar among the groups, the intubation success rate of the Glidescope was higher in the normal airway (100% vs 67%) and tongue oedema (89% vs. 50%) compared with the Airtraq (p=0.008 and p=0.009). The success rates with the paediatric manikin by the face-to-face approach were similar among the groups (50%) (p=0.7). The need for manoeuvres in the Glidescope was lower in the normal and tongue oedema models (p=0.02 and p=0.002). In addition, oesophageal intubation was low in the control and tongue oedema models with the Glidescope (p=0.03 and p<0.001). Novice personnel could more easily intubate the trachea with the Glidescope than with the Airtraq. Intubation with the Glidescope was superior to that with the Airtraq in the normal and tongue oedema models. The face-to-face intubation success rates were both low with both the Glidescope and Airtraq groups.

Tracheal intubation in patients immobilized by a rigid collar: a comparison of GlideScope and an intubating laryngeal mask airway.

Intubation must be rapidly performed with the utmost care in cervical trauma patients. We present the first comparison of GlideScope and an intubating laryngeal mask airway (ILMA) regarding insertion and intubation times, intubation success rates, mucosal damage, need for optimization maneuvers, effects on hemodynamic changes, and postoperative minor complications in a simulated cervical injury with a Philadelphia cervical collar. Ethics committee approval and patient consent were obtained and 94 American Society of Anesthesiology physical status I or II patients were enrolled in this study. Following standard anesthesia monitoring and induction, the Philadelphia-type cervical collar was applied and patients were subsequently intubated with ILMA or GlideScope. The total intubation success rates were similar between the groups (96%). The insertion (14.9 ± 10 s vs. 21.9 ± 6.5 s, respectively; P < 0.001) and intubation (43.5 ± 13 s vs. 48.4 ± 11 s; P = 0.02) times for ILMA were longer than for GlideScope. The total intubation times for ILMA were longer than the intubation time for GlideScope (43.5 ± 13 s vs. 85.6 ± 13 s; P < 0.001). The mucosal damage was higher in the ILMA group (P = 0.04). The two airway devices increased the heart rate and mean arterial pressure after insertion compared with the postinduction values within groups. GlideScope is superior to ILMA in terms of lower insertion and intubation times and lower levels of mucosal damage in cervical collar-immobilized patients.

Learning and performance of endotracheal intubation by paramedical students: Comparison of GlideScope(®) and intubating laryngeal mask airway with direct laryngoscopy in manikins.

Background and Aims:GlideScope video laryngoscope (GVL) and intubating laryngeal mask airway (I-LMA) may be used to facilitate intubation and secure the airway in patients with normal and abnormal airways. The aim of this study was to evaluate whether (GVL) and (I-LMA) facilitate and improve the tracheal intubation success rate and could be learned and performed easily by paramedic students when compared with Macintosh direct laryngoscopy (DL).Methods:This study was a prospective, randomised crossover trial that included 100 paramedic students. Macintosh DL, I-LMA and GVL were tested in both normal and difficult airway scenarios. Each participant was allowed up to three intubation attempts with each device, in each scenario. The time required to perform tracheal intubation, the success rate, number of intubation attempts and of optimisation manoeuvres and the severity of dental trauma were recorded. Statistical analysis was performed using Chi-square, one-way ANOVA, or Kruskal-Wallis test as appropriate, followed by post hoc test.Results:GVL and I-LMA required less time to successfully perform tracheal intubation, showed a greater success rate of intubation, reduced the number of intubation attempts and optimization manoeuvres required and reduced the severity of dental trauma compared to Macintosh DL in both normal and difficult airway scenarios.Conclusion:GVL and I-LMA provide better airway management than Macintosh DL in both normal and difficult airway scenarios.

Upper limb muscular activity and perceived workload during laryngoscopy: comparison of Glidescope® and Macintosh laryngoscopy in manikin: an observational study

BackgroundThe interaction between operators and their working environment during laryngoscopy is poorly understood. Numerous studies have focused on the forces applied to the patient's airway during laryngoscopy, but only a few authors have addressed operator muscle activity and workload. We tested whether different devices (Glidescope® and Macintosh) use different muscles and how these differences affect the perceived workload. MethodsTen staff anaesthetists performed three intubations with each device on a manikin. Surface electromyography was recorded for eight single muscles of the left upper limb. The NASA Task Load Index (TLX) was administered after each experimental session to evaluate perceived workload. ResultsA consistent reduction in muscular activation occurred with Glidescope® compared with Macintosh for all muscles tested (mean effect size d=3.28), and significant differences for the upper trapezius (P=0.002), anterior deltoid (P=0.001), posterior deltoid (P=0.000), and brachioradialis (P=0.001) were observed. The overall NASA-TLX workload score was significantly lower for Glidescope® than for Macintosh (P=0.006), and the factors of physical demand (P=0.008) and effort (P=0.006) decreased significantly. ConclusionsGreater muscular activity and workload were observed with the Macintosh laryngoscope. Augmented vision and related postural adjustments related to using the Glidescope® may reduce activation of the operator's muscles and task workload.

Comparison of GlideScope® Video Laryngoscope blades and ease of intubation in morbidly obese patients: a pilot study

Sharafudeen, S.; Abell, D.; Wadhwani, R. N.; Hassan, Z.; Patel, A.; Dasan, J. K. Author Information

Comparison of GlideScope® versus Macintosh laryngoscope for the removal of a hypopharyngeal foreign body: A randomized cross-over cadaver study

ObjectiveThis study aimed to evaluate whether GlideScope® is an effective and acceptable method for the removal of a hypopharyngeal foreign body. MethodsThis was a prospective study conducted in 28 first year emergency residents with little prior airway management experience. Participants extracted hypopharyngeal foreign bodies using a Macintosh laryngoscope and GlideScope® with Magill and Sponge forceps. The primary endpoints were extraction time and success rate with each device. Participant preferences were also assessed. ResultsThe cumulative success rate in relation to time to extraction was significantly higher with the Macintosh laryngoscope than with the GlideScope® (p<0.001) regardless of the extraction device. Significantly fewer attempts were required for the first successful extraction with the Macintosh laryngoscope versus GlideScope® with Magill forceps (p=<0.001) and Sponge forceps (p=<0.001). The time for successful foreign body extraction using GlideScope® was significantly lower when using Magill (median 46s, IQR 28–75s) forceps than Sponge forceps (median 79s, IQR 41–88s). ConclusionsIn this cadaver model, the Macintosh laryngoscope appeared to be more efficient and preferred than GlideScope® for extracting hypopharyngeal airway foreign bodies that are associated with fatal asphyxiation.

Orotracheal intubation of morbidly obese patients, comparison of GlideScope(®) video laryngoscope and the LMA CTrach™ with direct laryngoscopy.

Background:Morbidly obese patients are at increased risk of difficult mask ventilation and intubation as well as increased risk of hypoxemia during tracheal intubation. Recently, new video-assisted intubation devices have been developed. The GlideScope® videolaryngoscope and LMA CTrach™ (CT) allows continuous video-endoscopy of the tracheal intubation procedure.Objective:this study is to determine whether the GlideScope® videolaryngoscope (GVL) and the LMA CTrach™ (CT) provide the best airway management, measured primarily in intubation difficulty scale (IDS) scores, time and numbers of intubation attempts, and improvement in the intubation success rate of morbidly obese patients when compared with the direct Macintosh laryngoscope (DL).Materials and Methods:After Ethics’ Committee approval, 90 morbidly obese patients (BMI > 35 kg/m2) scheduled for general, gynecological, and bariatric surgery were included in this prospective study. Patients were randomly assigned in three groups: tracheal intubation using direct laryngoscopy (DL), GlideScope® videolaryngoscope (GVL) or the LMA CTrach™ (CT). Characteristics and consequences of airway management were evaluated. The primary outcome was the intubation difficulty scale score (IDS), Secondary outcomes were theintubation time, overall success rate, number of attempts, Cormack–Lehane grade, subjective difficulty of intubation, desaturation and upper airway morbidity.Results:Difficulty in facemask ventilation was similar in the three groups. IDS scores were significantly lower with GVL and CT than with DL. The mean TTI was 14 s faster in patients intubated with the GVL (86 s, IQR: 68-115) compared with DL (100 s, IQR; 80-150), and was 34 s faster when compared with CT (120 s, IQR; 95-180). The success rate of tracheal intubation was lower with the DL (80%) compared with the GVL (100%) or the CT (100%). Six cases of failed intubation occurred in group DL, four patients from the six patients were intubated successfully with GVL, and two patients were intubated with the CT. Both the GVL and the CTimproved the Cormack and Lehane view obtained at laryngoscopy, compared with the DL. Significantly high percent of patients in DL (43%) and CT (27%) required optimization maneuvers (external laryngeal pressure) compared with GVL (0%). In the CT group, 30% of the patients required laryngeal mask manipulation (for view optimization) compared with (0%) in GVL and CT groups.Conclusion:The GlideScope® videolaryngoscope and the LMA CTrach™ reduced the difficulty, improved laryngoscopic views and overall success rate of tracheal Intubationto a similar extent compared with the Macintosh laryngoscope in morbidly obese patients. The GVL improved intubation time for tracheal intubation compared with the CT and DL but no patient became hypoxic with CT because of prolonged intubation time.

A comparison of GlideScope® videolaryngoscopy with direct laryngoscopy for nasotracheal intubation in children

A comparison of GlideScope^® videolaryngoscopy with direct laryngoscopy for nasotracheal intubation in children

A comparison of GlideScope® videolaryngoscopy and direct laryngoscopy for nasotracheal intubation in children

The relative effectiveness of GlideScope(®) videolaryngoscopy (GV) for nasotracheal intubation in pediatric patients is unclear. The purpose of this study is to evaluate the usefulness of GV for nasotracheal intubation compared with direct laryngoscopy (DL) in pediatric patients. Our patient cohort consisted of 80 children <10 years of age who required nasotracheal intubation for elective dental or facial surgery. The patients were randomly allocated to GV (n = 40) or DL (n = 40) group. The time to intubation (TTI), glottic view grade, frequency of Magill forceps use, and degree of difficulty in intubation were evaluated. The median TTI was similar between the groups. The TTI of the former 20 patients was faster in the DL group (53.3 s, interquartile range: 42.0-64.3) than GV group (65.9 s, interquartile range: 56.0-93.9) (P = 0.007), whereas the TTI of the latter 20 patients was comparable between the groups. There were no significant differences in glottic view grade, frequency of Magill forceps use, and degree of difficulty in intubation between the two groups. GV can provide similar intubation performance characteristics compared with DL when used for nasotracheal intubation in pediatric patients. However, experience is needed to be skillful in the GV to acquire comparable TTI with DL.

Comparison of Glidescope® with the Macintosh blade in intubation without interruption of chest compressions: A manikin study

Purpose: The 2005 guidelines on Resuscitation emphasize on the importance of uninterrupted chest compressions in cardiac arrest (CA) victims. Rescuers should secure the victim’s airway at some point during CA. The purpose of the study was to compare the videolaryngoscope (Glidescope ® ) with the Macintosh blade in intubating the trachea with or without chest compressions in a manikin. Materials and methods: Forty-five medical school graduates with no previous experience in intubation were included in this study. The participants were tested in an ALS simulator (Laedral, Stavanger, Norway) in intubating a normal airway without chest compressions and in intubating a normal airway with continuous chest compressions. Chest compressions were delivered with the LUCASTM device. The success rate and the time to intubate the trachea were recorded. Results: All participants successfully intubated the trachea with both devices. In the “no compression” scenario, time to intubation with the Macintosh blade and the Glidescope® did not exhibit any statistical significance (Macintosh: 13.5 ± 2.3 s versus Glidescope®: 14.2 ± 3.1 s, p = NS). Intubation attempts were also not statistically significant with the use of either device. In the “compression” scenario, the time to intubation did not exhibit any significant difference between the 2 devices (Macintosh: 14.2 ± 3.2 s versus Glidescope ® : 13.2 ± 2.9 s, p = NS). However, significantly fewer intubation attempts were required with the Glidescope® compared to the Macintosh laryngoscope between the two groups (Table 1), Macintosh 5 participants versus Glidescope® 32 participants for the first attempt, p < 0.001.

Success of Endotracheal Intubation by Novice Users: A Comparison of Glidescope, Airtraq and Macintosh Laryngoscopes

Success of Endotracheal Intubation by Novice Users: A Comparison of Glidescope, Airtraq and Macintosh Laryngoscopes

Circulatory responses to nasotracheal intubation: comparison of GlideScope® videolaryngoscope and Macintosh direct laryngoscope

The GlideScope videolaryngoscope (GSVL) has been shown to have no special advantage over the Macintosh direct laryngoscope (MDL) in attenuating the circulatory responses to orotracheal intubation, but no study has compared the circulatory responses to nasotracheal intubation (NTI) using the two devices. This prospective randomized clinical study was designed to determine whether there was a clinically relevant difference between the circulatory responses to NTI with the GSVL and the MDL. Seventy-six adult patients were randomly allocated equally to the GSVL group and the MDL group. After induction of anesthesia, NTI was performed. Non-invasive blood pressure (BP) and heart rate (HR) were recorded before induction (baseline values) and immediately before intubation (post-induction values), at intubation and every minute for a further five minutes. During the observation, times required to reach the maximum values of systolic BP (SBP) and HR, times required for recovery of SBP and HR to postinduction values and incidence of SBP and HR percent changes > 30% of baseline values were also noted. The product of HR and systolic BP, i.e. rate pressure product (RPP), and the areas under SBP and HR vs. time curves (AUC(SBP) and AUC(HR)) were calculated. The NTI with the GSVL resulted in significant increases in BP, HR and RPP compared to postinduction values, but these circulatory changes did not exceed baseline values. BPs at all measuring points, AUC(SBP), maximum values of BP and incidence of SBP percent increase > 30% of baseline value during the observation did not differ significantly between groups. However, HR and RPP at intubation and their maximum values, AUC(HR) and incidence of HR percent increase > 30% of baseline value were significantly higher in the MDL group than in the GSVL group. Times required for recovery of SBP and HR to postinduction values were significantly longer in the MDL group than in the GSVL group. The pressor response to NTI with the GSVL and the MDL was similar, but the tachycardiac response to NTI was lesser and of a shorter duration when using a GSVL than when using an MDL.

Comparison of glidescope with the Macintosh laryngoscope for tracheal intubation in patients with simulated cervical spine immobilization

Comparison of glidescope with the Macintosh laryngoscope for tracheal intubation in patients with simulated cervical spine immobilization

Predictive value of the El-Ganzouri multivariate risk index for difficult tracheal intubation: a comparison of Glidescope® videolaryngoscopy and conventional Macintosh laryngoscopy

The predictive value of the El-Ganzouri risk index (EGRI) for difficult intubation has been evaluated using Macintosh laryngoscopy as reference standard. The Glidescope videolaryngoscope provides improved visualization of the glottis. We studied the predictive value of the EGRI using videolaryngoscopy as reference standard. Data from two subsequent groups of patients, intubated with Macintosh laryngoscopy (ML, n = 994) and videolaryngoscopy (VL, n = 843), were retrospectively analysed. The EGRI was taken as index test. The two types of laryngoscopy were adopted as reference for the presence of Cormack and Lehane grading III-IV. For both groups, sensitivity, specificity, and positive and negative post-test probabilities (PTP) were calculated for thresholds on the EGRI scale. Receiver operating characteristic curves and corresponding areas (AUC) were obtained. Sensitivity and specificity were 69.7% and 66.3% at the cut-off value of 2 in the ML group, and 93.3% and 76.6% at the cut-off value of 3 in the VL group. Corresponding positive and negative PTP were 12.81% and 3.15% in the ML group, and 6.73% and 0.16% in the VL group. At the threshold of 4, positive and negative PTP were 31.34% and 4.85% in the ML group. At the threshold of 7, positive and negative PTP were 85.71% and 1.08% in the VL group. The AUC was 0.74 in the ML group and 0.91 in the VL group. The predictive value of the EGRI may have been underestimated due to limited accuracy of Macintosh laryngoscopy. Using videolaryngoscopy, the EGRI might be reconsidered as a decisional tool.