Sun D A, Warriner C B, Parsons D G, Klein R, Umedaly H S, Moult M
Department of Anesthesia, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Br J Anaesth. 2005 Mar;94(3):381-4. doi: 10.1093/bja/aei041. Epub 2004 Nov 26.
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.
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.
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.
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.
GlideScope视频喉镜是一种新型的插管设备。其设计目的是在口腔、咽和气管轴线未对齐的情况下提供声门视野。本研究的目的是描述与直接喉镜检查相比，GlideScope在需要气管插管的择期手术患者中的应用情况。
200例患者被随机分配接受使用Macintosh 3号叶片的直接喉镜检查插管（DL组，n = 100）或使用GlideScope插管（GS组，n = 100）。插管前，由另一名麻醉师使用Macintosh 3号叶片对所有患者进行Cormack和Lehane（C&L）分级。然后由另一名麻醉师使用直接喉镜或GlideScope对患者进行插管，在此过程中检查喉部并给出喉镜检查评分。测量插管时间。
在GS组中，大多数C&L分级>1的患者（28/41）以及除1例之外的所有喉镜分级为3级的患者喉镜分级得到改善（P<0.001）。DL组的总体平均插管时间为30（95%CI 28 - 33）秒，GS组为46（95%CI 43 - 49）秒。两组中C&L分级为3级的患者插管时间相似，DL组为47秒，GS组为50秒。
在大多数患者中，GlideScope提供的喉镜视野等于或优于直接喉镜检查，但气管插管平均需要额外16秒。对于困难插管，它比标准直接喉镜检查具有潜在优势。
