Effectiveness and safety of the Levitan FPS Scope for tracheal intubation under general anesthesia with a simulated difficult airway

Canadian Journal of Anesthesia, 05/24/2012

Kok T et al. – The Levitan FPS (first pass success) Scope (LFS) in conjunction with the Macintosh laryngoscope does not improve the efficacy or safety of tracheal intubation in a simulated difficult airway.


  • Ninety–four subjects successfully completed the trial.
  • Manual in–line stabilization of the cervical spine was applied and the initial laryngoscopy was performed using either the Macintosh or the LFS in conjunction with the Macintosh.
  • Following the initial grading, a second laryngoscopy was repeated using the second randomized technique.
  • Cormack–Lehane grades, percentage of glottic opening (POGO) scores, time to intubate, number of intubation attempts, and the use of alternate techniques were recorded.
  • The anesthesiologist rated the subjective difficulty in using each technique with a numeric rating scale and a visual rating scale.


  • There was no significant difference in the primary outcome “good laryngoscopic views” (Cormack–Lehane grade 1 and 2) compared with “poor laryngoscopic views” (Cormack–Lehane grade 3 and 4) between the LFS and the Macintosh.
  • There were higher POGO scores with the LFS compared with the Macintosh (80% vs 20%, respectively; P<0.0001), but this did not translate to easier intubations, as documented by the need for an alternate intubation technique or time to intubate (<30 and <60sec, respectively).
  • The incidence of mucosal trauma, sore throat, and hemodynamic responses did not differ significantly between the two techniques.

Print Article Summary Cat 2 CME Report