Results 

 

 

Participating Operators. Ten staff anesthetists, 4 anesthesia residents, and one qualified anesthesia nurse volunteered and participated in this study. They performed laryngoscopy and tracheal intubation attempts with the Lo Pro Adult GlideScope Video Laryngoscope (LGVL) on from 16 to 42 (median: 24) patients. The operators were experienced users of the Standard Adult GlideScope Video Laryngoscope. 

 

Patient Demographics. During January and December 2006, 442 patients requiring orotracheal intubation for elective thyroid surgery were enrolled into this study; none of these patients was excluded from the study because of difficult face-mask ventilation experienced during induction of general anesthesia. The demographic data of the patients according to conventional laryngoscopic view grading (CLV) are summarized in Table 1. Laryngeal views of grade 1 to 5 at conventional laryngoscopy (CL) were obtained in 137, 103, 97, 96, and 9 patients, respectively. There were no statistically significant differences in age, height, weight, male/female ratio, body mass index, and American Society of Anesthesiologists physical status classification between the groups of CLV. The majority of the study patients were female usual in patients undergoing thyroid surgery.

 

Laryngeal Views in Patients with the First Attempt of Tracheal Intubation Successful. The success rate of LGVL-assisted tracheal intubation at the first attempt was 98.9 percent (437/442 patients). The laryngeal views obtained with the LGVL compared with CLV are shown in Table 2. The LGVL laryngeal views were always comparable or superior to those provided by CL. In summary, LGVL laryngeal views of grade 1, 2, and 3 were found in 351, 80, and 6 patients, respectively.

 

Minor Problems and Difficulties in Patients with the First Attempt of Tracheal Intubation Successful. Impeded tracheal tube (TT) advancement during oropharyngeal, laryngeal, and/or tracheal passage was encountered in altogether 16 percent (see Table 3). There were no problems with impeded blade insertion due to limited mouth opening and/or restricted pharyngeal space and poor visibility due to the presence of secretions and/or fogging of the camera system.

 

Causes of Primary Failures of Laryngoscopy and Tracheal Intubation. The causes of primary failures of LGVL-assisted tracheal intubation were failed TT advancement during laryngeal passage in 2 patients with CVL 3 and in 2 patients with CVL 4 and tracheal passage in one patient with CVL 5.

 

Laryngeal Views and Minor Problems and Difficulties in Patients with the Second Attempt of Tracheal Intubation Successful. The remaining 5 patients required a second attempt for successful LGVL-assisted tracheal intubation. The laryngeal views obtained with the LGVL during the second attempt were grade 1 and 2 in 2 and 3 patients, respectively. Impeded TT advancement was encountered during laryngeal passage in one patient with CVL 3 and tracheal passage in one patient with CLV 4.

 

Severe Complaints and Injuries Associated with Airway Management. Severe complaints and injuries to oropharyngeal, laryngeal, and/or tracheal structures associated with airway management were not observed at the postanesthesia care unit and during the postanesthesia visit on the first postoperative day at the normal ward.   

 

 

Discussion