Comparison of Intubation time with GlideScope® and McIntosh Laryngoscope in Obese Patients
Wasinwong, W.; Pukdeetanakul, V.; Kanchanawanitkul, O.; Sriyannaluk, B.
Journal of the Medical Association of Thailand 100(3): 306-312
2017
ISSN/ISBN: 0125-2208 PMID: 29911789 Document Number: 14670
Difficult intubation is more frequent in obese than in lean patients. The GlideScope® is a videolaryngoscope that provides a laryngoscopic view equal to or better than a direct laryngoscope in non-obese patients. To compare the intubation time between the GlideScope® and the McIntosh laryngoscope in obese patients. The authors randomly allocated 46 obese patients (BMI >28 kg/m2) with the American Society of Anesthesiologists physical status I to III, scheduled for elective surgery under general anesthesia with oroendotracheal intubation into either the McIntosh group (Group M) or the GlideScope® group (Group G). The age range was 18 to 65 years old. Intubation was performed by anesthetic residents with experience in the use of the GlideScope® at least 10 times. The intubation time, the laryngoscopic view, the number of intubations and success rate, the number of optimizing maneuvers, vital signs, and complications from intubation were recorded. The intubation time in Group G (31 seconds) was not different from Group M (29 seconds). There was a significant difference in laryngoscopic view between the two groups. The laryngoscopic view was grade 2 in Group M and was grade 1 in Group G (p = 0.007). All patients in Group G were successfully intubated in the first attempt. There were two patients in Group M who needed more than one attempt. One of these needed a second intubation and another one was successful on the third attempt with the GlideScope®. However, there was no statistical significance in the overall success rate. The heart rate, blood pressure and complications were not statistically different. The intubation time and the success rate between the McIntosh blade and GlideScope® in obese patients was not significantly different. Nevertheless, the GlideScope® provided a better laryngoscopic view than the McIntosh blade.
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