• Olivier Belze, Evan Lepage, Yvan Bazin, Pierre Kerourin, Jacques Fusciardi, Francis Remérand, and Fabien Espitalier.
• From the Department of Anaesthesia, Hôpital Foch, Suresnes, France (OB, EL); and Department of Anaesthesia, Pôle Anesthésie Réanimation, Université François-Rabelais, CHRU de Tours, Tours Cedex 09, France (YB, PK, JF, FR, FE).
• Eur J Anaesthesiol. 2017 Jul 1; 34 (7): 456-463.

BackgroundDouble-lumen tracheal tube (DLT) insertion can be managed with videolaryngoscopes such as the Glidescope or indirect laryngoscopes like the Airtraq DL. No study has compared both devices when a difficult intubation is predicted.ObjectiveOur hypothesis was that the Glidescope is superior to the Airtraq for double-lumen tube insertion in patients with a predicted or known difficult airway.DesignRandomised study.PatientsAdults scheduled for thoracic elective surgery, requiring one-lung ventilation with a predicted difficult intubation score of at least 7 (Arné risk index).InterventionBetween March 2014 and March 2015, adult patients, scheduled for elective thoracic surgery, requiring double-lumen tracheal tube placement, and with a predicted risk (evaluated preoperatively using the Arné score) or a history of difficult intubation, were allocated to a Glidescope or an Airtraq group.Main Outcome MeasuresThe primary outcome was the overall success rate of tracheal intubation after two attempts. Secondary outcomes were success rates on the first attempt, duration of intubation, need for laryngeal pressure, Cormack and Lehane grade and side-effects.ResultsOf 277 patients, 78 were predicted to have a difficult airway. Finally, 72 patients were enrolled. Neither the overall success rates of tracheal intubation [Glidescope group 31/36 (86%) versus Airtraq group 34/36 (94%), P = 0.43] nor the side-effects differed between groups. There was no difference concerning visualisation of the glottis using the Cormack and Lehane grade (P = 0.18) or intubation time [Glidescope group 67 s (49 to 90) versus Airtraq group 81 s (59 to 101), P = 0.28]. All patients with a previous history of difficult intubation were intubated successfully.ConclusionThere is no difference in success rates of tracheal intubation with a double-lumen tube in patients with a predicted or known difficult airway when using either a Glidescope or Airtraq device.Trial RegistrationNational register of the French National Agency for Medicines and Health Products Safety No. 2014-A00143-44.

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