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BJA Advance Access published online on June 19, 2009
British Journal of Anaesthesia, doi:10.1093/bja/aep164
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© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Tracheal intubation with videolaryngoscopes in patients with cervical spine immobilization: a randomized trial of the Airway Scope® and the GlideScope®

E. H. C. Liu1,*, R. W. L. Goy1, B. H. Tan1 and T. Asai2

1 Department of Anaesthesia, National University Health System, National University of Singapore, Singapore
2 Department of Anesthesiology, Kansai Medical University, Takii Hospital, Osaka, Japan

* Corresponding author. E-mail: analiue{at}nus.edu.sg

Background: The GlideScope® (Verathon Inc., Bothell, WA, USA) and Airway Scope® (Hoya Corp., Tokyo, Japan) have both been used for difficult airway management, including in patients with cervical spine pathology. The Airway Scope®'s disposable blade has a tube channel to guide tracheal tube insertion through the glottis. Our hypothesis is that this tube guidance system improves the ease of tracheal intubation compared with the GlideScope®, which does not have a tube guiding system. We tested this hypothesis in a randomized comparison of the two videolaryngoscopes in patients whose cervical spines were immobilized.

Methods: Seventy consenting patients were randomized to have tracheal intubation with the GlideScope® (n=35) or the Airway Scope® (n=35). In all patients, we applied manual in-line stabilization of the cervical spine throughout airway management. All the airway procedures were carried out by two anaesthetists experienced in the use of both videolaryngoscopes.

Results: The tracheal intubation time was 34.2 (SD 25.1) s with the Airway Scope® compared with 71.9 (47.9) s with the GlideScope® (P<0.001). Tracheal intubation was successful with the Airway Scope® in 35 (100%) patients compared with 31 (88.6%) patients with the GlideScope® (P=0.114). Tracheal intubation was successful within 60 s in 33 (94.3%) patients with the Airway Scope® and 22 (62.9%) patients with the GlideScope® (P=0.003).

Conclusions: These results suggest that the Airway Scope®'s tube guide system enables more rapid tracheal intubation compared with the GlideScope® in patients with cervical spine immobilization.

Keywords: anaesthetic techniques, laryngoscopy; equipment, laryngoscopes


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