• Eur J Anaesthesiol · Mar 2009

    Comparative Study Clinical Trial

    Videolaryngoscopy in the management of the difficult airway: a comparison with the Macintosh blade.

    • Konstantinos Stroumpoulis, Alexandra Pagoulatou, Magda Violari, Irini Ikonomou, Nausika Kalantzi, Kalliopi Kastrinaki, Theodoros Xanthos, and Christina Michaloliakou.
    • Department of Anaesthesiology, 'Metaxa' Cancer Hospital of Piraeus, Greece. arkaskostas@yahoo.gr
    • Eur J Anaesthesiol. 2009 Mar 1; 26 (3): 218-22.

    Background And ObjectiveSeveral studies have shown that videolaryngoscopes can provide better laryngeal exposure than conventional laryngoscopy. These studies, however, did not exclusively focus on patients with an anticipated difficult intubation. The aim of the present study was to assess whether a videolaryngoscope would provide better laryngeal exposure than conventional laryngoscopy and therefore facilitate intubation in cases of difficult laryngoscopy.MethodsOne hundred and twelve patients with an estimated difficult intubation, scheduled to undergo surgical operations, requiring general anaesthesia and endotracheal intubation, were included in the study. Direct laryngoscopy with a Macintosh blade was performed, followed by videolaryngoscopy and intubation attempt(s). The laryngeal views obtained by each method were recorded according to the Cormack/Lehane scale.ResultsThe percentage of Cormack-Lehane I and II views obtained by conventional laryngoscopy rose from 63.4 to 90.2% (P < 0.0005) with videolaryngoscopy, whereas Cormack-Lehane III and IV views declined from 36.6 to 9.8% (P < 0.0005). Intubation was successful in 98.2% of the cases.ConclusionIn patients with an anticipated difficult airway, videolaryngoscopy significantly improved the laryngeal exposure thus facilitating endotracheal intubation.

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