A comparison of the McGrath®Series 5 videolaryngoscope and Macintosh laryngoscope for double-lumen tracheal tube placement in patients with a good glottic view at direct laryngoscopy

Abstract Background Double lumen endotracheal tube (DLT) is the most widely used method for lung isolation in current thoracic anesthesia practice. In recent years, the routine application of videolaryngoscope for tracheal intubation has gradually increased, but there are still few related reports. We doubted whether we could get benefits from applying the videolaryngoscope for double-lumen tracheal tube placement in patients with predicted normal airways. Therefore, this study was designed to compare the clinical performance of GlideScope ® , C-MAC ® (D) videolaryngoscope and Macintosh laryngoscope in DLT intubation. Methods 90 adult patients with no predictors for difficult airways were allocated randomly into three groups. All the patients were anesthsized by a routine anesthesia process with different laryngoscopes according to the result of allocation. We accessed DLT insertion time, first-pass success rate, numerical rating scale (NRS) of DLT delivery, NRS of DLT insertion and Cormack-Lehane degree(C/L degree). The hemodynamic change and the incidence of intubation complications were also recorded. Results Compared with GlideScope, Macintosh resulted in shorter time for DLT insertion (median:96(IQR:51[min-max:62–376]s v 73(26[48-419]s, p=0.003), but there was no difference between Macintosh and C-MAC(D) (p=0.610). As for the success at the first attempt, Macintosh was significantly associated with higher successful rate compared with GlideScope and C-MAC(D) (p=0.001, p=0.028, respectively). NRS of DLT delivery and NRS of DLT insertion were significantly lower in Macintosh group than others (p<0.001, respectively). However, C/L degree (I/II A /II B /III) in Macintosh group was statistically higher than others (p<0.001, respectively). The incidence of oral bleeding, hoarseness, sore throat and dental trauma were low in all groups (p>0.05, respectively). There were no statistical difference about DLT misplacement, fibreoptic time and hemodynamic changes among three groups. Conclusions GlideScope ® and C-MAC ® (D) videolaryngoscopes may not be recommended as the first choice for routine DLT intubation in patients with predicted normal airways.

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The Effect of Fiberoptic Bronchoscopy-guided Technique for Placement of a Left-sided Double-lumen Tube on the Intubation Performance Compared with the Conventional Method Using a Macintosh Laryngoscope

The Open Anesthesia Journal ◽

10.2174/2589645802014010115 ◽

2020 ◽

Vol 14 (1) ◽

pp. 115-122

Author(s):

Jung A. Lim ◽

In-Young Kim ◽

Sung Hye Byun

Keyword(s):

Thoracic Surgery ◽

Endotracheal Tube ◽

Conventional Method ◽

Macintosh Laryngoscope ◽

Tube Placement ◽

Fiberoptic Bronchoscope ◽

Double Lumen ◽

Double Lumen Endotracheal Tube ◽

Endotracheal Tube Placement ◽

Initial Placement

Background: The accurate placement of the double-lumen endotracheal tube is imperative for effective one-lung ventilation in thoracic surgery. Malpositioning and repositioning of a misplaced tube may cause excessive trauma. Objective: We hypothesized that the fiberoptic bronchoscope-guided method for double-lumen endotracheal tube placement would reduce the incidence of malpositioning as compared to the conventional method using the Macintosh laryngoscope. Methods: Fifty patients scheduled to undergo elective thoracic surgery were recruited and randomly assigned to the fiberoptic bronchoscope-guided [n=25; Group F] and conventional [n=25; Group C] method groups, according to the method of double-lumen endotracheal tube placement. The primary outcome was the incidence of double-lumen endotracheal tube malpositioning observed under the fiberoptic bronchoscope after initial placement. Secondary outcomes included the times for placement, confirmation, and total procedure of double-lumen endotracheal tube intubation. Results: The incidence of malpositioning after initial double-lumen endotracheal tube placement was significantly lower in Group F than in Group C (20.0% vs 68.0%). In addition, the time for placement was significantly higher in Group F than in Group C, and that for confirmation was significantly lower in Group F than in Group C. Conclusion: The fiberoptic bronchoscope-guided method for double-lumen endotracheal tube placement can reduce the incidence of malpositioning after initial placement and expedite the intubation process with a double-lumen endotracheal tube in thoracic surgery.

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Failure of Double-lumen Endobronchial Tube Placement

Anesthesiology ◽

10.1097/00000542-198701000-00019 ◽

1987 ◽

Vol 66 (1) ◽

pp. 83-85 ◽

Cited By ~ 19

Author(s):

SHIGEYUKI SAITO ◽

SHUJI DOHI ◽

KEIICHI TAJIMA

Keyword(s):

Tube Placement ◽

Double Lumen ◽

Double Lumen Endobronchial Tube

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Should the Glidescope video laryngoscope be used first line for all oral intubations or only in those with a difficult airway? A review of current literature

Journal of Perioperative Practice ◽

10.1177/1750458918788985 ◽

2018 ◽

Vol 28 (12) ◽

pp. 322-333 ◽

Cited By ~ 3

Author(s):

Terrie-Marie Russell ◽

Anil Hormis ◽

Keyword(s):

Difficult Airway ◽

Success Rate ◽

Macintosh Laryngoscope ◽

Review Literature ◽

Video Laryngoscope ◽

Intubation Time ◽

First Line ◽

Glottic View ◽

Glidescope Video Laryngoscope ◽

Difficult Airways

The purpose of this study was to review literature that looked into the efficacy of the Glidescope video laryngoscope versus the Macintosh laryngoscope in oral endotracheal intubations. We aimed to answer the question ‘Should the Glidescope video laryngoscope laryngoscopes be used as first line intubation aids or only in the difficult airway?’ A systematic search of electronic databases was made. The inclusion criteria included: Glidescope, video laryngoscope, and Macintosh laryngoscope in human studies. The study aimed to compare first attempt success rate, glottic view and intubation time in papers dating between 2009 and 2017. Eleven trials with a total of 7,919 patients with both difficult and normal airways were included. The trials showed an improvement in first attempt success rate and glottic view with the Glidescope video laryngoscope especially in those with difficult airways. Overall time to intubate showed no significant differences between the Glidescope video laryngoscope and the Macintosh laryngoscope although it was identified that with increased training and experience with the Glidescope video laryngoscope, intubation time was reduced. Glidescope video laryngoscopes show advantages over the Macintosh laryngoscopes in obtaining better glottic views in those with difficult airways. However its use is not supported in all routine intubations.

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