GlideScope Versus Flexible Fiber Optic for Awake Upright Laryngoscopy - 17/02/12
, Scott T. Youngquist, MD, MS a, Michael P. Mallin, MD a, Joseph R. Bledsoe, MD a, b, Erik D. Barton, MD, MS a, Erika D. Schroeder, MD a, Amber D. Bledsoe, MD a, b, Deborah A. Axelrod, MD b
Address for correspondence: Natalie Anne Silverton, MDRésumé |
Study objectives |
We compare laryngoscopic quality and time to highest-grade view between a face-to-face approach with the GlideScope and traditional flexible fiber-optic laryngoscopy in awake, upright volunteers.
Methods |
This was a prospective, randomized, crossover study in which we performed awake laryngoscopy under local anesthesia on 23 healthy volunteers, using both a GlideScope video laryngoscopy face-to-face technique with the blade held upside down and flexible fiber-optic laryngoscopy. Operator reports of Cormack-Lehane laryngoscopic views and video-reviewed time to highest-grade view, as well as number of attempts, were recorded.
Results |
Ten women and 13 men participated. A grade II or better view was obtained with GlideScope video laryngoscopy in 22 of 23 (95.6%) participants and in 23 of 23 (100%) participants with flexible fiber-optic laryngoscopy (relative risk GlideScope video laryngoscopy versus flexible fiber-optic laryngoscopy 0.96; 95% confidence interval 0.88 to 1.04). Median time to highest-grade view for GlideScope video laryngoscopy was 16 seconds (interquartile range 9 to 34) versus 51 seconds (interquartile range 35 to 96) for flexible fiber-optic laryngoscopy. A distribution of interindividual differences demonstrated that GlideScope video laryngoscopy was, on average, 39 seconds faster than flexible fiber-optic laryngoscopy (95% confidence interval 0.2 to 76.9 seconds).
Conclusion |
GlideScope video laryngoscopy can be used to obtain a Cormack-Lehane grade II or better view in the majority of awake, healthy volunteers when an upright face-to-face approach is used and was slightly faster than traditional flexible fiber-optic laryngoscopy. However, flexible fiber-optic laryngoscopy may be more reliable at obtaining high-grade views of the larynx. Awake, face-to-face GlideScope use may offer an alternative approach to the difficulty airway, particularly among providers uncomfortable with flexible fiber-optic laryngoscopy.
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| Supervising editor: Henry E. Wang, MD, MS |
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| Author contributions: NAS, STY, MPM, and EDB conceived and designed the study and obtained institutional review board approval. NAS, STY, MPM, and JRB undertook recruitment of the participants, performed the procedures, and collected data. EDS, ADB, and DAA reviewed the videos for number of attempts and time until grade II view was obtained. NAS and STY analyzed the data, with STY performing the majority of the statistical analysis. NAS and EDB drafted the article. STY contributed substantially to its revision. NAS takes responsibility for the paper as a whole. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist. |
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| Publication date: Available online August 10, 2011. |
Vol 59 - N° 3
P. 159-164 - mars 2012 Retour au numéro
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