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GlideScope Versus Flexible Fiber Optic for Awake Upright Laryngoscopy Full Text
Annals of Emergency Medicine, 08/15/2011
Silverton NA et al.– GlideScope video laryngoscopy can be used to obtain a Cormack–Lehane grade II or better view in the majority of awake, healthy volunteers when an upright face–to–face approach is used and was slightly faster than traditional flexible fiber–optic laryngoscopy. However, flexible fiber–optic laryngoscopy may be more reliable at obtaining high–grade views of the larynx. Awake, face–to–face GlideScope use may offer an alternative approach to the difficulty airway, particularly among providers uncomfortable with flexible fiber–optic laryngoscopy.
Methods- This was a prospective, randomized, crossover study in which the authors performed awake laryngoscopy under local anesthesia on 23 healthy volunteers, using both a GlideScope video laryngoscopy face–to–face technique with the blade held upside down and flexible fiber–optic laryngoscopy.
- Operator reports of Cormack–Lehane laryngoscopic views and video–reviewed time to highest–grade view, as well as number of attempts, were recorded.
- Ten women and 13 men participated.
- A grade II or better view was obtained with GlideScope video laryngoscopy in 22 of 23 (95.6%) participants and in 23 of 23 (100%) participants with flexible fiber–optic laryngoscopy (relative risk GlideScope video laryngoscopy versus flexible fiber–optic laryngoscopy 0.96; 95% confidence interval 0.88 to 1.04).
- Median time to highest–grade view for GlideScope video laryngoscopy was 16 seconds (interquartile range 9 to 34) versus 51 seconds (interquartile range 35 to 96) for flexible fiber–optic laryngoscopy.
- A distribution of interindividual differences demonstrated that GlideScope video laryngoscopy was, on average, 39 seconds faster than flexible fiber–optic laryngoscopy (95% confidence interval 0.2 to 76.9 seconds).