Measurement of forces applied using a Macintosh direct laryngoscope compared with a Glidescope video laryngoscope in patients with predictors of difficult laryngoscopy

Cordovani, Daniel; Russell, T.; Wee, Wallace; Suen, Andrew; Cooper, Richard M.

doi:10.1097/eja.0000000000000901

Cited by 33 publications

(39 citation statements)

References 19 publications

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“…The forces measured by the three sensors were summated and were not individually analyzed. According to previous studies, [5][6][7] peak force (the maximum force recorded, expressed as newton [N]) and impulse force (integral of total force over time for laryngoscopy, expressed as newtonÁsecond [NS]) were calculated. Median and top 10 th percentile values were calculated as relevant indicators of each force index, and median and top 10 th percentile values (with confidence intervals [CI]) of the paired differences between direct and indirect laryngoscopy were used for comparisons.…”

Section: Ethical Approval For This Study (Number 16-5213-ae) Was Provmentioning

confidence: 99%

Direct versus indirect laryngoscopy using a Macintosh video laryngoscope: a mannequin study comparing applied forces

Gordon

Bertram

Cavallin

et al. 2020

Can J Anesth/J Can Anesth

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Purpose Upper airway injury and sympathetic activation may be related to the forces applied during laryngoscopy. We compared the applied forces during laryngoscopy using direct and indirect visualization of a standardized mannequin glottis. Methods Force transducers were applied to the concave surface of a GlideScope T-MAC Macintosh-style video laryngoscope that can also be used as a conventional direct-view laryngoscope. Thirty-four anesthesiologists performed four laryngoscopies (two direct and two

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Section: Ethical Approval For This Study (Number 16-5213-ae) Was Provmentioning

confidence: 99%

Direct versus indirect laryngoscopy using a Macintosh video laryngoscope: a mannequin study comparing applied forces

Gordon

Bertram

Cavallin

et al. 2020

Can J Anesth/J Can Anesth

Self Cite

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“…However, there remain factors to be optimized for successful GlideScope intubation such as adequate molding of the endotracheal tube with a stylet and operator experience with the device 12 . Despite the improved laryngeal view, previous studies have shown that the GlideScope takes equivalent or even prolonged intubation time than a direct laryngoscope 6,8,9,19 , and the prolonged intubation time is mainly due to prolonged tube delivery to the larynx 11,13 . Therefore, our study aim was to demonstrate the usefulness of the twist tube for easily handling and delivery of the endotracheal tube in infants.…”

Section: Discussionmentioning

confidence: 99%

“…In studies of GlideScope intubation, technical difficulty was most likely to be associated with tube delivery to the laryngeal inlet requiring prolonged laryngoscopy time and operator experience 6,11,13 , and this difficulty was more prominent in infants with challenging airways 14 . Despite manipulating the tube tip angle imitating the GlideScope blade shape, the tube tip still tends to be placed posterior or to the right side of the laryngeal inlet 15 requiring additional handling to place the tube tip at the center of the laryngeal inlet.…”

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confidence: 99%

The usefulness of endotracheal tube twisting in facilitating tube delivery to glottis opening during GlideScope intubation in infants: randomized trial

Min

Shin

et al. 2020

Sci Rep

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Despite an excellent view of the glottis, technical difficulties with endotracheal tube delivery remains in GlideScope intubation. We evaluated whether a spiral-shape twisted tube can facilitate placement of the tracheal tube tip at the center of glottis opening compared to conventional tube for GlideScope intubation in infants. eighty-six infants were randomly placed in either the conventional tube group (group C) or the twist tube group (group T). In group T, the shaft of the tube was manually twisted into a loose spiral shape. the primary outcome was the initial center location of the tube tip at the glottis opening, and the secondary outcome was total tube handling time. The initial center location rate of the tube tip at the glottis opening was significantly higher in group T than in group C (88% [38/43] vs. 47% [20/43], P < 0.001). In addition, total tube handling time (sec) was significantly shorter in group T than in group C (15.4 ± 4.7 vs. 18.2 ± 5.3, P = 0.012). In this study, the spiral shape twist tube successfully improved the rate of initial center location of the tube tip at glottis opening and facilitated tube delivery in GlideScope intubation in infants.

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“…Thus, the rate of minor injury in the midline approach was lower than that in the right approach in theory. Increasing evidence has indicated that the video laryngoscope has an established role in tracheal intubation, decreasing the forces applied to the soft tissues of the upper airway and incidence of complications, compared with the Macintosh laryngoscope [18][19][20] . However, we found no difference in the rates of adverse events between the approaches in contrast to these studies and Israel's results.…”

Section: Discussionmentioning

confidence: 99%

The midline approach for endotracheal intubation using GlideScope video laryngoscopy could provide better glottis exposure in adults： A randomized controlled trial

Jiang

Qiu

Zhang

et al. 2019

Preprint

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Background: Previous studies have demonstrated that the common laryngoscopic approach (right-sided) and midline approach are both used for endotracheal intubation by direct laryngoscopy. Although the midline approach is commonly recommended for video laryngoscopy (VL) in the clinic, there is a lack of published evidences to support this practice. This study aimed to evaluate the effects of different video laryngoscopic approaches on intubation. Methods: Two hundred sixty-two patients aged 18 years who underwent elective surgery under general anaesthesia and required endotracheal intubation were included in the present prospective, randomized, controlled study. The participants were randomly and equally allocated to the right approach (Group R) or midline approach (Group M). All the intubations were conducted by experienced anaesthetists using GlideScope video laryngoscopy. The primary outcomes were Cormack-Lehane laryngoscopic views (CLVs) and first-pass success (FPS) rates. The secondary outcomes were the time to glottis exposure, time to tracheal intubation, haemodynamic responses and other adverse events. Comparative analysis was performed between the groups. Results: Finally, 262 patients completed the study, and all the tracheas were successfully intubated. No significant differences were observed in the patient characteristics and airway assessments ( P >0.05). Compared with Group R, Group M had a better CLV ( χ2 =14.706, P =0.001) and shorter times to glottis exposure (8.82±2.04 vs 12.38±1.81; t =14.94; P <0.001) and tracheal intubation (37.19±5.01 vs 45.23±4.81; t =13.25; P <0.001), but no difference was found in the FPS rate (70.2% vs 71.8%; χ2 =0.074; P =0.446) and intubation procedure time (29.86±2.56 vs 30.46±2.97, t =1.75, P =0.081). Between the groups, the rates of hoarseness or sore throat, minor injury, hypoxemia and changes in SBP and HR showed no significant difference ( P >0.05). Conclusion: Although the FPS rate did not differ based on the laryngoscopic approach, the midline approach could provide better glottis exposure and shorter times to glottis exposure and intubation. The midline approach should be recommended for teaching in VL-assisted endotracheal intubation. Trial registration: The study was registered in the Chinese Clinical Trial Registry ( ChiCTR-RNC-1900023252 ).

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Measurement of forces applied using a Macintosh direct laryngoscope compared with a Glidescope video laryngoscope in patients with predictors of difficult laryngoscopy

Cited by 33 publications

References 19 publications

Direct versus indirect laryngoscopy using a Macintosh video laryngoscope: a mannequin study comparing applied forces

Direct versus indirect laryngoscopy using a Macintosh video laryngoscope: a mannequin study comparing applied forces

The usefulness of endotracheal tube twisting in facilitating tube delivery to glottis opening during GlideScope intubation in infants: randomized trial

The midline approach for endotracheal intubation using GlideScope video laryngoscopy could provide better glottis exposure in adults： A randomized controlled trial

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