Endotracheal tube introducer-assisted intubation with the GlideScope video laryngoscope

Conklin, Lori D.; Cox, William Sands; Blank, Randal S.

doi:10.1016/j.jclinane.2009.08.004

Cited by 7 publications

(3 citation statements)

References 8 publications

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“…We speculate that this was due to the difference in techniques between stylet and bougie. After passing through the glottis, bougies tend to sag downwards due to gravity, leaning towards the posterior part of the glottis [26]. To facilitate tracheal tube entry over the bougie, it is necessary to rotate it while advancing [25].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the success rate of tracheal intubation between stylet and bougie with a hyperangulated videolaryngoscope: a randomised controlled trial

Eum,

Ji,

Kim

2023

Anaesthesia

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SummaryHyperangulated videolaryngoscopes are known to increase the success rate of tracheal intubation in the setting of difficult airway management when used with a stylet or bougie. However, there is controversy over which adjunct is more useful. This randomised study aimed to compare first attempt tracheal intubation success rate between a stylet and bougie when using a hyperangulated videolaryngoscope. We recruited patients aged > 20 years who were scheduled for elective surgery under general anaesthesia and required tracheal intubation. We only included patients with factors predicting difficult tracheal intubation based on pre‐anaesthesia airway evaluation. Tracheal intubation was attempted using a Glidescope® with either a stylet or bougie as an adjunct according to group assignment. Primary outcome was the success rate of the first tracheal intubation attempt, and secondary outcomes were success of second and third attempts; tracheal intubation time; and occurrence of sore throat, dysphagia or hoarseness. A total of 166 patients were included. The success rate of the first tracheal intubation attempt was significantly higher in patients allocated to the bougie group compared with those allocated to the stylet group (81/83 (98%) vs. 73/83 (88%), respectively; p = 0.032). The number of patients who needed two attempts was significantly lower in those allocated to the bougie group compared with those allocated to the stylet group (1/83 (1%) vs. 9/83 (11%), respectively; p = 0.018). Each group had one patient (1%) where tracheal intubation was achieved after a third attempt. There was no significant difference in the occurrence of sore throat, dysphagia and hoarseness between the two groups. When difficult tracheal intubation is anticipated and a hyperangulated videolaryngoscope is used, the success rate of the first attempt is higher when a bougie is used compared with a stylet.

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Section: Discussionmentioning

confidence: 99%

Comparison of the success rate of tracheal intubation between stylet and bougie with a hyperangulated videolaryngoscope: a randomised controlled trial

Eum,

Ji,

Kim

2023

Anaesthesia

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“…The bevel of the distal portion of the ETT can hang on the arytenoid cartilages or impact against the front wall of the larynx, preventing and making it difficult to guide the ETT through the vocal cords into the trachea. This is particularly difficult in patients with unanticipated anterior airway, protruding upper teeth, small chin, and thyroid-mental distance less than 6 cm, where the angle acute ETT can prevent the progress and the insertion of the ETT through the vocal cords [16, 17]. …”

Section: Discussionmentioning

confidence: 99%

GlideScope and Frova Introducer for Difficult Airway Management

Ciccozzi

Angeletti

Guetti

et al. 2013

Case Reports in Anesthesiology

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The introduction into clinical practice of new tools for intubation as videolaringoscopia has dramatically improved the success rate of intubation and the work of anesthesiologists in what is considered the most delicate maneuver. Nevertheless intubation difficulties may also be encountered with good anatomical visualization of glottic structures in videolaringoscopia. To overcome the obstacles that may occur both in a difficult provided intubation such as those unexpected, associated endotracheal introducer able to facilitate the passage of the endotracheal tube through the vocal cords into the trachea may be useful. We report 4 cases of difficult intubation planned and unplanned and completed successfully using the GlideScope videolaryngoscope associated with endotracheal Frova introducer.

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“…A number of case reports have suggested modifications of VAEI to avoid some of the above issues including the use of a Mallinckrodt Satin‐Slip Intubating Stylet (Mallinckrodt, Inc., St. Louis, MO)9 and flexible bronchoscopes10–12 as introducers for the endotracheal tube. For laryngologic surgical cases, the described technique is utilized in our institution for patients with tenuous glottic airways, poor neck extension, and who are not candidates for standard direct laryngoscopy intubation.…”

Section: Discussionmentioning

confidence: 99%

Reducing injury during video‐assisted endotracheal intubation: The “Smart Stylet” concept

Weissbrod

Meratı

2011

The Laryngoscope

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Objectives: Video-assisted endoscopic intubation (VAEI) has gained wide use in anesthesiology when difficult intubation is encountered. Even when excellent visualization of the larynx is achieved with VAEI, successful intubation can be difficult and/or traumatic due to awkward angles and rigid stylets. Presented is a modification of standard VAEI procedure that allows for minimization of intubation trauma.Methods: Technical description of VAEI with ''smart stylet'' for laryngeal surgical patients.Results: For difficult intubations, a GlideScope TM , a type of VAEI, is used in combination with a flexible bronchoscope acting as a ''smart'' stylet. The bronchoscope is not used for its light or fiberoptic capacity, but rather as a manipulatable stylet for the endotracheal tube. The technical description of this technique is presented with illustrative images and online video content.Conclusions: The ''smart stylet'' concept allows for successful and safe endotracheal intubation when used with the Glidescope TM .

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Endotracheal tube introducer-assisted intubation with the GlideScope video laryngoscope

Cited by 7 publications

References 8 publications

Comparison of the success rate of tracheal intubation between stylet and bougie with a hyperangulated videolaryngoscope: a randomised controlled trial

Comparison of the success rate of tracheal intubation between stylet and bougie with a hyperangulated videolaryngoscope: a randomised controlled trial

GlideScope and Frova Introducer for Difficult Airway Management

Reducing injury during video‐assisted endotracheal intubation: The “Smart Stylet” concept

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