A comparative study of the efficacy of Glidescope versus Macintosh direct laryngoscopy for intubation in pediatric patients undergoing cardiac surgery

Saudi J Anaesth. 2021 Oct-Dec;15(4):419-423. doi: 10.4103/sja.sja_472_21. Epub 2021 Sep 2.

Abstract

Background: The Glidescope is a novel, portable, reusable video laryngoscope that has provided superior laryngeal visualization to facilitate tracheal intubation, especially in the management of difficult airways. In this study, we aimed to compare the efficacy of the Glidescope (video-laryngoscope) against the Macintosh direct laryngoscope.

Methods: Fifty patients were randomly selected via simple randomization using computer-generated random numbers, and sorted into two groups of 25 patients: the Glidescope group and the Macintosh group. We included pediatric patients undergoing cardiac surgery for the repair of congenital heart disease. Those with suspected difficult intubation, preterm babies with low body weight, and patients at risk of aspiration were all excluded.

Results: Patients' baseline demographic and clinical characteristics were found to be comparable in the two groups. The mean intubation time was 24.1 ± 13.6 s in the Glidescope group, as compared to 18.1 ± 5.9 s in the Macintosh group. Blade insertion was easy in 92% and 96% of the patients in the Glidescope and Macintosh groups, respectively. Tracheal intubation was considered easy in 84% of the Glidescope group, compared to 92% of the Macintosh group. There was a statistically significant correlation between the ease of tracheal intubation and the used intubation method (rho = -0.35; P = 0.014).

Conclusion: Our findings indicate that the Glidescope can be used as an efficient modality for obtaining successful intubations with no complications. Ease of tracheal intubation was the only outcome that was found to be affected by the used modality. Further investigations with proper sample sizes are needed.

Keywords: Airway; general anesthesia; intubation; laryngoscopy; pediatric.