A Step Ahead for Difficult Airway Management Using GlideScope®: A Prospective, Randomised, Comparative Study

Abstract

Background and Aim: Different techniques have been developed in order to optimise the practice of intubation with GlideScope® (Verathon Inc, Bothell, Washington, USA) video-assisted laryngoscope. This study aimed to demonstrate the use of a new, safe, and effective technique by inserting both the video-assisted laryngoscope blade and endotracheal tube (ETT) together. Methods: A prospective, randomised study was conducted with 50 patients who were anticipated as difficult for endotracheal intubation, aged 18–90 years, with an American Society of Anesthesiologists’ (ASA) classification of Grades I–IV, and who presented for elective surgery. The patients were divided into 2 groups of 25 participants: an intubation with traditional GlideScope (TG) technique group, and combined GlideScope (CG) and ETT simultaneous insertion group. The optimal glottic view and the time-to-intubation were recorded. Postintubation airway trauma and both practitioners’ and patients’ satisfaction were documented. The categorical data are presented as a number and percentage and were subjected to Fisher’s exact or Chi-square test for analysis. The statistical significance was p≤0.05. Results: The optimal glottic view was 64% in TG and 72% in CG (p=0.216); intubation was achieved within ≤15 secs in 22 patients in TG and all patients in CG (p=0.077); and 88% of patients in TG showed high satisfaction scores compared to 92% in CG (p=0.646). The practitioners’ satisfaction was 76% in TG and 96% in CG (p=0.042). Conclusion: Simultaneous insertion of both the GlideScope blade and ETT could provide fast, effective, and safe endotracheal intubation.