• BMC anesthesiology · Jun 2020

    Videolaryngoscopy versus direct laryngoscopy for double-lumen endotracheal tube intubation in thoracic surgery - a randomised controlled clinical trial.

    GlideScope-Titanium videolaryngoscopy improved glottic visualisation but prolonged intubation time for placement of double lumen tubes.

    • Joachim Risse, Ann-Kristin Schubert, Thomas Wiesmann, Ansgar Huelshoff, David Stay, Michael Zentgraf, Andreas Kirschbaum, Hinnerk Wulf, Carsten Feldmann, and Karl Matteo Meggiolaro.
    • Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany. joachim.risse@uk-essen.de.
    • BMC Anesthesiol. 2020 Jun 16; 20 (1): 150.

    BackgroundDouble-lumen tube (DLT) intubation is necessary for thoracic surgery and other operations with the need for lung separation. However, DLT insertion is complex and might result in airway trauma. A new videolaryngoscopy (GVL) with a thin blade might improve the intubation time and reduce complexity as well as iatrogenic airway complications compared to conventional direct laryngoscopy (DL) for DLT intubation.MethodsA randomised, controlled trial was conducted in 70 patients undergoing elective thoracic surgery using DLT for lung separation. Primary endpoint was time to successful intubation. The secondary endpoints of this study were number of intubation attempts, the assessment of difficulty, any complications during DLT intubation and the incidence of objective trauma of the oropharynx and supraglottic space and intubation-related subjective symptoms.Results65 patients were included (DL group [n  =  31], GVL group [n  =  34]). Median intubation time (25th-75th percentiles) in GVL group was 93 s (63-160) versus 74 (58-94) in DL group [p = 0.044]. GVL resulted in significantly improved visualisation of the larynx (Cormack and Lehane grade of 1 in GVL group was 97% vs. 74% in DL Group [p = 0.008]). Endoscopic examinations revealed significant differences in GVL group compared to DL group showing less red-blooded vocal cord [p = 0.004], vocal cord haematoma [p = 0.022] and vocal cord haemorrhage [p = 0.002]. No significant differences regarding the postoperative subjective symptoms of airway were found.ConclusionsVideolaryngoscopy using the GlideScope®-Titanium shortly prolongs DLT intubation duration compared to direct laryngoscopy but improves the view. Objective intubation trauma but not subjective complaints are reduced.Trial RegistrationGerman Clinical Trial Register DRKS00020978, retrospectively registered on 09. March 2020.

      Pubmed     Free full text   Copy Citation  

      Add institutional full text...

    This article appears in the collection: Are video laryngoscopes superior to standard laryngoscopy?.



    GlideScope-Titanium videolaryngoscopy improved glottic visualisation but prolonged intubation time for placement of double lumen tubes.

    Daniel Jolley  Daniel Jolley
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..