GlideScope® versus C-MAC®(D) videolaryngoscope versus Macintosh laryngoscope for double lumen endotracheal intubation in patients with predicted normal airways: a randomized, controlled, prospective trial
Open Access
- 20 May 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Anesthesiology
- Vol. 20 (1), 1-8
- https://doi.org/10.1186/s12871-020-01012-y
Abstract
Background The double lumen endotracheal tube (DLT) is the most widely-used device for single lung ventilation in current thoracic anesthesia practice. In recent years, the routine application of the videolaryngoscope for single lumen endotracheal intubation has increased; nevertheless there are few studies of the use of the videolaryngoscope for DLT. We wondered whether there were benefits to using the videolaryngoscope for DLT placement in patients with predicted normal airways. Therefore, this study was designed to compare the performances of the GlideScope (R), the C-MAC (R)(D) videolaryngoscope and the Macintosh laryngoscope in DLT intubation. Methods This was a randomized, controlled, prospective study. We randomly allocated 90 adult patients with predicted normal airways into three groups. All patients underwent routine anesthesia using different laryngoscopes according to group allocation. We compared DLT insertion times, first-pass success rates, numerical rating scales (NRS) of DLT delivery and DLT insertion, Cormack-Lehane degrees (C/L), hemodynamic changes and incidences of intubation complications. All outcomes were analyzed using SPSS13.0. Results Compared with the GlideScope, the Macintosh gave shorter times for DLT insertion (median: 96 (IQR: 51 [min-max: 62-376] s vs 73 (26 [48-419] s, p = 0.003); however, there was no difference between the Macintosh and C-MAC(D) (p = 0.610). The Macintosh had a significantly higher successful first attempt rate than did the GlideScope or C-MAC(D) (p = 0.001, p = 0.028, respectively). NRS of DLT delivery and insertion were significantly lower in the Macintosh than in the others (p < 0.001). However, the C/L degree in the Macintosh was significantly higher than in the others (p < 0.001). The incidences of oral bleeding, hoarseness, sore throat and dental trauma were low in all groups (p > 0.05). There were no significant differences in DLT misplacement, fiberoptic time or hemodynamic changes among the groups. Conclusions Compared with the Macintosh laryngoscope, the GlideScope (R) and C-MAC (R)(D) videolaryngoscopes may not be recommended as the first choice for routine DLT intubation in patients with predicted normal airways.Other Versions
This publication has 18 references indexed in Scilit:
- Randomized controlled trial comparing the McGrath videolaryngoscope with the C-MAC videolaryngoscope in intubating adult patients with potential difficult airwaysBritish Journal of Anaesthesia, 2012
- Comparison of the GlideScope® videolaryngoscope and the Macintosh laryngoscope for double‐lumen tube intubationAnaesthesia, 2012
- Glidescope® video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysisCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 2011
- A randomised, controlled crossover comparison of the C-MAC videolaryngoscope with direct laryngoscopy in 150 patients during routine induction of anaesthesiaBMC Anesthesiology, 2011
- VideolaryngoscopyCurrent Anaesthesia & Critical Care, 2010
- Video‐laryngoscopes in the adult airway management: a topical review of the literatureActa Anaesthesiologica Scandinavica, 2010
- Lung isolation techniques for patients with difficult airwayCurrent Opinion in Anaesthesiology, 2010
- Management of the predicted difficult airway: a comparison of conventional blade laryngoscopy with video-assisted blade laryngoscopy and the GlideScopeEuropean Journal of Anaesthesiology, 2010
- Videolaryngoscopy in the management of the difficult airway: a comparison with the Macintosh bladeEuropean Journal of Anaesthesiology, 2009
- Prophylactic Dexamethasone Decreases the Incidence of Sore Throat and Hoarseness After Tracheal Extubation with a Double-Lumen Endobronchial TubeAnesthesia & Analgesia, 2008