A Macintosh Laryngoscope Blade for Videolaryngoscopy Reduces Stylet Use in Patients with Normal Airways

• DOI: 10.1213/ane.0b013e3181ae39db
• Publication Date: 2009-08-15T07:14:22Z
• Authors: André van Zundert; Ralph Maassen; Ruben Lee; Remi Willems; Michel Timmerman; Marc Siemonsma; Marc Buise; Marco Wiepking
• Keywords: Stylet; Tracheal tube; Elective surgery; Epiglottis

BACKGROUND: Although most tracheal intubations with direct laryngoscopy are not performed a styletted endotracheal tube, it is recommended that stylet can be used indirect videolaryngoscopy. Recently, there were several reports of complications associated tubes and In this study, we compared three videolaryngoscopes (VLSs) in patients undergoing intubation for elective surgery: the GlideScope® Ranger™ (GlideScope, Bothell, WA), V-MAC™ Storz® Berci DCI® (Karl Storz, Tuttlingen, Germany), McGrath® (McGrath series 5, Aircraft medical, Edinburgh, UK) tested whether feasible to intubate trachea videolaryngoscopy without using stylet. METHODS: Four hundred fifty consecutive adults (ASA PS I–II) surgery randomly allocated airway management one devices. Anesthesia induction consisted fentanyl-propofol-rocuronium. An independent anesthesiologist Cormack-Lehane grading system score an initial laryngoscopic view classic metal Macintosh blade. After subsequent positive-pressure ventilation face mask oxygen-sevoflurane mixture 1 min, was intubated VLSs. During intubation, following data collected: time, number attempts, use extra tools facilitate overall satisfaction conditions. RESULTS: The every patient VLSs, none required conversion laryngoscope. All VLSs offered equal or better glottis as assessed by mean grade, traditional laryngoscopy, including larger viewing angle glottic entrance. average time 34 ± 20 s GlideScope, 18 12 V-MAC 38 23 McGrath VLS. Intubation Storz faster (P < 0.05) than other two VLS necessitated fewer additional 0.01), resulting higher first-pass successful rate. A had 7% group versus about 50% when used. CONCLUSIONS: large proportion normal airways successfully certain blades stylet, although studied clearly differ outcome. displaces soft tissues fashion scope, affording room tube insertion limiting need scopes. offer advantages, visualization entrance conditions, good laryngeal does guarantee easy insertion. We recommend geometry blade design, should more detail.