Comparison of the GlideScope^® videolaryngoscope and the Macintosh laryngoscope for double‐lumen tube intubation

Abstract

Summary Intubation with a double‐lumen tube is important for achieving one‐lung ventilation and facilitating thoracic surgery. The GlideScope® videolaryngoscope (Verathon Inc., Bothell, WA, USA) is designed to assist tracheal intubation for patients with a difficult airway. We wished to compare the GlideScope and direct laryngoscopy for double‐lumen tube intubation. Sixty adult patients requiring a double‐lumen tube for thoracic surgery and predicted uncomplicated laryngoscopy were randomly assigned to a direct Macintosh laryngoscopy group (n = 30) or a GlideScope group (n = 30). The mean (SD) duration of intubation was longer in the Macintosh group (62.5 (29.7) s) than in the GlideScope group (45.6 (10.7) s; p = 0.007). There was no difference in the success of the first attempt at intubation (26/30 (87%) and 30/30 (100%) for Macintosh and GlideScope groups, respectively; p = 0.112). The incidence of sore throat and hoarseness was higher in the Macintosh group (18 (60%) and 14 (47%), respectively) than in the GlideScope group (6 (20%) and 4 (13%), respectively; p = 0.003 and 0.004). We conclude that double‐lumen tube intubation in patients with predicted normal laryngoscopy is easier using the GlideScope videolaryngoscope than the Macintosh laryngoscope.

Comparison of McGRATH MAC and Macintosh laryngoscopes for double-lumen endotracheal tube intubation by anesthesia residents: a prospective randomized clinical trial

“…In recent years, videolaryngoscopic devices have been introduced as important tools in the management of patients with expected or unexpected difficult airways and emergent airway management [12,13]. Videolaryngoscopes, such as the GlideScope (Verathon, Bothell, WA), Pentax-AWS Airwayscope (Pentax, Tokyo, Japan), and Airtraq (Prodol, Las Arenas, Spain), incorporate acute blade and introduce designs with angles greater than the traditional McL design [14,15]. One retrospective study demonstrated that videolaryngoscopes are superior to the McL for DLT intubation [16].…”

McGrath Series 5 videolaryngoscope vs Airtraq DL videolaryngoscope for double-lumen tube intubation

“…[13] Briefly, the DLT were lubricated and pre-curved with a malleable stylet. [9,31] After the distal tip of the DLT entered the glottis, the stylet was removed. Following this, sequential rotation or a “left-to-right” rotation was used to advance the tube pass through the glottis.…”

A modified technique to improve the outcome of intubation with a left-sided double-lumen endobronchial tube

“…However, there are few data concerning the hemodynamic response to laryngoscopy with a GVL when intubating with a DLT. Our previous studies found only small differences in the hemodynamic response to intubation when using a video-assisted airway device compared with direct laryngoscopy [6,21]. The size and structure of the DLT also likely explain these observations.…”

“…The size and structure of a DLT can make it difficult to place correctly when using a VL, reducing the chances of success, prolonging intubation and increasing the risk of adverse events compared with an SLT either with direct laryngoscopy [14] or with a GVL [6,15]. This study followed on from our previous research [3], which showed that DLT intubation is straightforward when using a GVL in patients with a normal airway.…”

“…In recent years several video-assisted laryngoscopes, such as the GlideScope ® video laryngoscope (GVL; Verathon, Bothell, WA), have been developed, and have been shown to reduce the time taken to intubate with a DLT [6]. Nonetheless, the DLT must be angulated to fit the curve of the GVL’s blade, and the incidence of the common complications of tracheal intubation, such as hoarseness and sore throat, appear not to be reduced [7].…”