Document Detail


Poor visualization during direct laryngoscopy and high upper lip bite test score are predictors of difficult intubation with the GlideScope videolaryngoscope.
MedLine Citation:
PMID:  18420866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The GlideScope videolaryngoscope allows equal or superior glottic visualization compared with direct laryngoscopy, but predictive features for difficult GlideScope intubation have not been identified. We undertook this prospective study to identify patient characteristics associated with difficult GlideScope intubation. METHODS: Demographic and morphometric factors were recorded preoperatively for 400 patients undergoing anesthesia with endotracheal intubation. After induction, direct laryngoscopy was performed in all patients to assess the Cormack and Lehane grade of glottic visualization followed by GlideScope intubation. The number of attempts and time needed for intubation were recorded. Univariate and multivariate analyses were performed to identify the characteristics associated with difficult GlideScope intubation. RESULTS: Intubation required 1, 2, and 3 attempts in 342, 48, and 9 participants, respectively, with one failure. Mean time for intubation was 21 +/- 14 s. After univariate analysis, the following characteristics were significantly correlated (P < 0.05) with longer time to intubate and/or multiple attempts: older age, male sex, history of snoring, high Mallampati class, small mouth opening, short sternothyroid and manubriomental distances, large neck circumference, high upper lip bite test score, and high Cormack and Lehane grade during direct laryngoscopy. However, after introducing these variables in nominal logistic and proportional hazard multiple regression models, only high Cormack and Lehane grade during direct laryngoscopy, high upper lip bite test score, and short sternothyroid distance were significantly associated with multiple attempts or lengthier intubations. CONCLUSION: Despite a high success rate, intubation with the GlideScope is likely to be more challenging in patients with high Cormack and Lehane grade during direct laryngoscopy, high upper lip bite test score, or short sternothyroid distance.
Authors:
Marie-Hélène Tremblay; Stephan Williams; Arnaud Robitaille; Pierre Drolet
Related Documents :
18817156 - Randomized double blind comparison between sciatic-femoral nerve block and propofol-rem...
10530656 - A clinical trial of propofol vs midazolam for procedural sedation in a pediatric emerge...
8738906 - Midazolam intravenous conscious sedation in oral surgery. a retrospective study of 372 ...
20237046 - Inhaled fluticasone propionate reduces postoperative sore throat, cough, and hoarseness.
1531046 - Efficacy of prophylactic sclerotherapy for prevention of a first variceal hemorrhage.
19764826 - Use of a vascular reconstruction device to salvage acute ischemic occlusions refractory...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  106     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-18     Completed Date:  2008-05-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1495-500, table of contents     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, CHUM, Hôpital Notre-Dame, 1560 Sherbrooke East, Montréal, Canada, H2L 4M1.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Equipment Design
Female
Glottis / anatomy & histology*
Humans
Intubation, Intratracheal / adverse effects,  instrumentation*
Jaw Relation Record*
Laryngoscopes*
Laryngoscopy*
Lip
Logistic Models
Male
Middle Aged
Neck / anatomy & histology
Proportional Hazards Models
Prospective Studies
ROC Curve
Risk Assessment
Risk Factors
Surgical Procedures, Elective
Time Factors
Video Recording

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The impact of different step changes of inspiratory fraction of oxygen on functional residual capaci...
Next Document:  Fiberoptic intubation through an I-gel supraglottic airway in two patients with predicted difficult ...