A randommized, prospective, controlled trial of Glidscope®, C-MAC®(D) videolaryngoscope and Macintosh laryngoscope for double lumen endotracheal intubation in patients with predicted normal airways
Background Double lumen endotracheal tube (DLT) is the most widely used method for lung isolation in current thoracic anesthesia practice. In recent years, the routine application of videolaryngoscope for tracheal intubation has gradually increased, but there are still few related reports. We doubted whether we could get benefits from applying the videolaryngoscope for double-lumen tracheal tube placement in patients with predicted normal airways. Therefore, this study was designed to compare the clinical performance of GlideScope ® , C-MAC ® (D) videolaryngoscope and Macintosh laryngoscope in DLT intubation. Methods 90 adult patients with no predictors for difficult airways were allocated randomly into three groups. All the patients were anesthsized by a routine anesthesia process with different laryngoscopes according to the result of allocation. We accessed DLT insertion time, first-pass success rate, numerical rating scale (NRS) of DLT delivery, NRS of DLT insertion and Cormack-Lehane degree(C/L degree). The hemodynamic change and the incidence of intubation complications were also recorded. Results Compared with GlideScope, Macintosh resulted in shorter time for DLT insertion (median:96(IQR:51[min-max:62–376]s v 73(26[48-419]s, p=0.003), but there was no difference between Macintosh and C-MAC(D) (p=0.610). As for the success at the first attempt, Macintosh was significantly associated with higher successful rate compared with GlideScope and C-MAC(D) (p=0.001, p=0.028, respectively). NRS of DLT delivery and NRS of DLT insertion were significantly lower in Macintosh group than others (p0.05, respectively). There were no statistical difference about DLT misplacement, fibreoptic time and hemodynamic changes among three groups. Conclusions GlideScope ® and C-MAC ® (D) videolaryngoscopes may not be recommended as the first choice for routine DLT intubation in patients with predicted normal airways.