Routine Use of Glidescope and Macintosh Laryngoscope by Trainee Anesthetists

Area of Science:

• Anesthesiology
• Medical Devices
• Airway Management

Background:

• Direct laryngoscopy using the Macintosh laryngoscope (MCL) is a standard technique for endotracheal intubation.
• Videolaryngoscopes offer an indirect view of the glottis, potentially improving intubation outcomes.

Purpose of the Study:

• To compare the efficacy and ease of endotracheal intubation between the Glidescope Videolaryngoscope (GVL) and the Macintosh laryngoscope (MCL) performed by anesthesia trainees.
• To evaluate intubating conditions, success rates, and difficulty scores associated with each device.

Main Methods:

• A comparative study was conducted with 80 adult patients (ASA I-II) with normal airways undergoing elective surgery.
• Patients were randomized into two groups: GVL and MCL.
• Intubations were performed by trainee residents with prior experience (>1 year, >50 successful intubations per device). Cormack and Lehane's (C&L's) score, percentage of glottis opening (POGO), time to intubation, and difficulty scores were assessed.

Main Results:

• The GVL group demonstrated significantly better glottic visualization (C&L's score, p < 0.001) and higher POGO scores (88.25 ± 22.06 vs. 57.25 ± 29.26, p < 0.001) compared to the MCL group.
• Intubation time was shorter with the GVL (32.90 ± 8.69 vs. 41.33 ± 15.29 seconds, p = 0.004).
• Overall difficulty scores were significantly lower with the GVL (2.78 ± 1.39 vs. 4.85 ± 1.75, p < 0.001).

Conclusions:

• Anesthesia trainees experienced faster and easier endotracheal intubation with the GVL compared to the MCL in patients with normal airways.
• The GVL provided superior glottic view, contributing to improved intubation efficiency and reduced perceived difficulty.