Comparison of Macintosh Laryngoscope and GlideScope® for Orotracheal Intubation in Children Older Than One Year

Comparison of Macintosh Laryngoscope and GlideScope® for Orotracheal Intubation in Children Older Than One YearA irway anatomy and physiology vary among adults and children and are major factors in increasing morbidity and mortality rates during tracheal intubation.The Macintosh laryngoscope remains the most commonly used tracheal intubation device among children.[1] Many devices exist for difficult intubation such as the video laryngoscope (GlideScope [GVL]; Verathon Medical, Bothell, WA, Storz, Airtraq) and the fiberoptic bronchoscope.[2,3] Fiberoptic bronchoscopes and supraglottic airway devices are useful techniques for difficult pediatric intubation.[4] GVL has been designed specifically for difficult intubation cases, and in many adult studies it has been shown to reduce airway trauma and, therefore, assist significantly in glottis visualization.[5][6][7][8] Few prospective studies exist on Objectives: We aim to investigate intubation conditions, intubation times, and hemodynamic response with the GlideScope video laryngoscope or the Macintosh direct laryngoscope for orotracheal intubation in children older than one year.Methods: Eighty patients aged 1-12 years, scheduled to undergo elective surgery under general anesthesia with endotracheal intubation were included in a prospective, single-blinded, randomized trial.Exclusion criteria were risk of pulmonary aspiration, craniofacial malformation, difficult intubation, emergency surgery, cardiovascular disease, respiratory disease, and hemodynamic instability.After standard anesthesia induction, patients were randomized into two groups.The group G patients (n=40) were intubated with the GlideScope and the group M patients (n=40) were intubated with the Macintosh laryngoscope.Intubation time, number of attempts, Cormack-Lehane score, airway maneuvers, and visual analog score were recorded.Hemodynamic variables were recorded before and after anesthesia induction, at intubation, and 1., 3., and 5. minutes after intubation.Student's t-test, Mann-Whitney U test, and the χ 2 test were used for statistical analysis, with p<0.05 considered significant.Results: The demographic data, operation time and hemodynamic parameters were similar between the two groups.The intubation time was longer in Group G than Group M. The incidence of Cormack-Lehane score 1 was higher in Group G than Group M while Cormack-Lehane score 2 was higher in Group M. Conclusion: We concluded that the GlideScope video laryngoscope provided better glottis visualization, but prolonged intubation time.There was no superiorty on hemodynamic effect with the video laryngoscope.