Results

 

 

Participating Operators. Eight staff anesthetists, 2 anesthesia residents, and one qualified anesthesia nurse volunteered and participated in this study. They performed laryngoscopy and tracheal intubation attempts with the GlideScope Ranger Video Laryngosope (GRVL) on from 6 to 12 (median: 8) patients. The operators were experienced users of the Lo Pro Adult GlideScope Video Laryngoscope. 

 

Patient Demographics. During March and May 2007, 108 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 38, 28, 22, 18, and 2 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 and Success of Tracheal Intubation. In all patients, GRVL-assisted tracheal intubation was successful at the first attempt. The laryngeal views obtained with the GRVL compared with CLV are shown in Table 2. The GRVL laryngeal views were always comparable or superior to those provided by CL. In summary, GRVL laryngeal views of grade 1 and 2 were obtained in 102 and 6 patients, respectively.

 

Minor Problems and Difficulties. Impeded tracheal tube (TT) advancement during oropharyngeal, laryngeal, and/or tracheal passage were encountered in altogether 20 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.

 

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