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.
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