Document Detail

Force and pressure distribution using Macintosh and GlideScope laryngoscopes in normal and difficult airways: a manikin study.
MedLine Citation:
PMID:  21965048     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The forces applied to the soft tissues of the upper airway may have a deleterious effect. This study was designed to evaluate the performance of the GlideScope compared with the Macintosh laryngoscope.
METHODS: Twenty anaesthetists and 20 trainees attempted tracheal intubation of a Laerdal SimMan manikin. Forces and pressure distribution applied by both laryngoscope blades onto the soft upper airway tissues were measured using film pressure transducers. The minimal force needed to achieve a successful intubation, in the same simulated scenario, was measured; additionally, we considered the visualization score achieved by using the Cormack-Lehane grades.
RESULTS: All participants applied, on average, lower force with the GlideScope than with the Macintosh in each simulated scenario. Forces [mean (sd)] applied in the normal airway scenario [anaesthetists: Macintosh 39 (22) N and GlideScope 27 (15) N; trainees: Macintosh 45 (24) N and GlideScope 21 (15) N] were lower than forces applied in the difficult airway scenario [anaesthetists: Macintosh 95 (22) N and GlideScope 66 (20) N; trainees: Macintosh 100 (38) N and GlideScope 48 (16) N]. All the intubations using the GlideScope were successful, regardless of the scenario and previous intubation experience. The average pressure on the blades was 0.13 MPa for the Macintosh and 0.07 MPa for the GlideScope, showing a higher uniformity for the latter.
CONCLUSIONS: The GlideScope allowed the participants to obtain a successful intubation applying a lower force. A flatter and more uniform pressure distribution, a higher successful rate, and a better glottic view were observed with the GlideScope.
M Carassiti; R Zanzonico; S Cecchini; S Silvestri; R Cataldo; F E Agrò
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-09-28
Journal Detail:
Title:  British journal of anaesthesia     Volume:  108     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-13     Completed Date:  2012-01-23     Revised Date:  2012-04-19    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  146-51     Citation Subset:  IM    
Department of Anaesthesia, University Campus Bio-Medico, Via Álvaro del Portillo, 200, 00128 Rome, Italy.
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MeSH Terms
Analysis of Variance
Data Interpretation, Statistical
Equipment Design
Glottis / anatomy & histology
Laryngoscopes / adverse effects*
Laryngoscopy / adverse effects*,  education,  methods*
Transducers, Pressure
Comment In:
Br J Anaesth. 2012 Apr;108(4):698; author reply 698   [PMID:  22419625 ]

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