GlideScope® Versus C-MAC® Video Laryngoscopy in Pediatric Intubation. Does Time Matter?

Abstract

Background: The emergence of video laryngoscopy in the management of pediatric airways has been invaluable as it has been known that these patients are prone to airway complications. Video laryngoscopes are proven to improve glottic view in both normal and difficult airways in pediatric patients. The time taken to intubate using these devices is inconsistent. Objectives: This study was designed to compare the time to intubate using two common video laryngoscopes, C-MAC®, and GlideScope®, aimed at pediatric patients age 3 - 12 years old. Methods: A Randomized controlled trial was conducted in 65 ASA I or II patients, aged 3 - 12 years old who underwent elective surgery using endotracheal tube. They were divided into group 1 patients who were intubated using C-MAC® video laryngoscope versus group 2 patients who were intubated with GlideScope® video laryngoscope. Laryngoscopists were all anesthetists with experience in both C-MAC® and GlideScope® intubation. Time to intubate and intubation attempts were measured. Any extra maneuver, airway complications, and laryngoscopist satisfaction scores were also recorded. Results: Total time to intubate was significantly longer in GlideScope® group than in C-MAC® group (P < 0.001). Both devices managed to achieve excellent glottic views. The first pass attempt success rate was similar between both devices. There was no difference between requirement of extra maneuvers to assist intubations. There were also no adverse events associated with all the intubations. The satisfaction score of anesthetists was comparable to each other. Conclusions: Even though intubation time using GlideScope® is longer, both devices give excellent glottic view, comparable success intubation, and anesthetists satisfaction score.

Network meta-analysis of comparative efficacy and safety of intubation devices in children

“…Of the 23 included studies, 20 studies 12 – 14 , 30 – 39 , 41 – 44 , 46 , 47 , 49 explicitly reported methods for generating random sequence, and 13 studies 13 , 31 , 32 , 34 , 35 , 37 – 40 , 42 , 43 , 47 , 48 described methods for performing allocation concealment. Most studies 12 – 14 , 30 – 43 did not blind participants and personnel.…”

“…Among the included studies, a total of 16 studies 11 , 13 , 14 , 30 – 35 , 38 – 40 , 42 , 43 , 46 , 47 , involving 1288 patients, reported the data of LC for 10 intubation devices. Network meta-analysis suggested that Airtraq significantly reduced the risk of LC compared with Macintosh (OR = 0.14, 95%CI = 0.03 to 0.69) and Pentax (OR = 29.17, 95%CI = 1.93 to 440.66).…”