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BJA Advance Access originally published online on August 26, 2009
British Journal of Anaesthesia 2009 103(5):755-760; doi:10.1093/bja/aep232
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© The Author [2009]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Comparison of the performance of four laryngoscopes in a high-fidelity simulator using normal and difficult airway

L. Powell1, J. Andrzejowski1, R. Taylor2 and D. Turnbull1,*

1 Department of Anaesthesia, Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK
2 Research Department, Sheffield Teaching Hospitals NHS Trust, 463a Glossop Road, Sheffield S10 2QD, UK

* Corresponding author. E-mail: david.turnbull{at}sth.nhs.uk

Background: Novel laryngoscopes may demonstrate advantages over the traditional Macintosh laryngoscope for difficult airways. Our study compared Glidescope® laryngoscope, Bonfils fibrescope, and CTrachTM intubating laryngeal mask airway with the Macintosh laryngoscope in a simulated normal and difficult airway, considering the additional effect of previous intubation experience.

Methods: Twenty-two non-anaesthetists, 21 trainees, and 20 consultant anaesthetists attempted tracheal intubation of a Laerdal® SimMan manikin, comparing a normal with a difficult airway scenario for each intubation device. The time taken to view the vocal cords and time to intubate were recorded. Also success rate and ease of use for each device were scored, alongside scope preference for each scenario.

Results: Time to intubate was significantly shorter with the Macintosh compared with all three novel devices. All the devices had a high first-attempt success rate, but the Glidescope® had a 100% first time successful intubation for all participants in both a normal and a difficult airway. Non-anaesthetists took significantly longer time to intubate compared with consultant anaesthetists, but there was no difference between trainee and consultant anaesthetists. Higher proportions of participants found the Glidescope® easy to use, compared with other devices. For the normal airway, the Macintosh was the preferred device, but for the difficult airway, the Glidescope® was favoured.

Conclusions: In this study, the Macintosh laryngoscope outperformed the other devices. However, the Glidescope® was considered easy to use regardless of previous experience and was the preferred device for the simulated difficult airway.

Keywords: equipment; Macintosh laryngoscope, Glidescope® laryngoscope, Bonfils fibreoptic scope, CTrachTM ILMA, manikin; tracheal intubation, difficult airway


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