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BJA Advance Access published online on November 26, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aei041
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted October 26, 2004

Clinical Investigation

The GlideScope® Video Laryngoscope: randomized clinical trial in 200 patients

D. A. Sun 1, C. B. Warriner 1*, D. G. Parsons 1, R. Klein 1, H. S. Umedaly 1, and M. Moult 1

1 Department of Anesthesia, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada

* To whom correspondence should be addressed.
C. B. Warriner, E-mail: bwarrine{at}vanhosp.bc.ca


  Abstract

Background. The GlideScope® Video Laryngoscope is a new intubating device. It was designed to provide a view of the glottis without alignment of the oral, pharyngeal and tracheal axes. The aim of the study was to describe the use of the GlideScope® in comparison with direct laryngoscopy for elective surgical patients requiring tracheal intubation.

Methods. Two hundred patients were randomly assigned to intubation by direct laryngoscopy using a Macintosh size 3 blade (DL, n=100) or intubation using the GlideScope® (GS, n=100). Prior to intubation all patients were given a Cormack and Lehane (C&L) grade by a separate anaesthetist using a Macintosh size 3 blade. The patient was then intubated, using direct laryngoscopy or the GlideScope®, by a different anaesthetist during which the larynx was inspected and given a laryngoscopy score. Time to intubate was measured.

Results. In the GS group, laryngoscopy grade was improved in the majority (28/41) of patients with C&L grade >1 and in all but one of patients who were grade 3 laryngoscopy (P<0.001). The overall mean time to intubate was 30 (95% CI 28-33) s in the DL group and 46 (95% CI 43-49) s in the GS group. The time to intubate for C&L grade 3 was similar in both groups, being 47 s for the DL group and 50 s for the GS group respectively.

Conclusion. In most patients, the GlideScope® provided a laryngoscopic view equal to or better than that of direct laryngoscopy, but it took an additional 16 s (average) for tracheal intubation. It has potential advantages over standard direct laryngoscopy for difficult intubations.

Keywords: anaesthetic techniques, laryngoscopy; equipment, GlideScope®; equipment, video laryngoscope; intubation, tracheal.
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