PMID- 23687227
OWN - NLM
STAT- MEDLINE
DCOM- 20130827
LR  - 20130621
IS  - 1526-7598 (Electronic)
IS  - 0003-2999 (Linking)
VI  - 117
IP  - 1
DP  - 2013 Jul
TI  - A comparative trial of the GlideScope(R) video laryngoscope to direct 
      laryngoscope in children with difficult direct laryngoscopy and an evaluation of 
      the effect of blade size.
PG  - 176-81
LID - 10.1213/ANE.0b013e318292f0bf [doi]
AB  - BACKGROUND: GlideScope(R) video laryngoscope (GVL) has been proposed to be useful 
      for airway management, but its efficacy for difficult airways has not been 
      confirmed in pediatric patients. In this study, we evaluated the usefulness of 
      the GVL for improving the laryngoscopic view in patients whose Cormack and Lehane 
      grade (C&L grade) was >/=3 under direct laryngoscopy. We also assessed the effect 
      of GVL blade size on the laryngoscopic view. METHODS: This randomized open trial 
      was conducted in a tertiary pediatric center. Patients whose previous C&L grade 
      was >/=3, or who were anticipated to have a difficult airway, were enrolled. The 
      initial modified C&L grade was scored using a direct laryngoscope (DL). If the 
      patient's C&L grade was >/=3, the laryngoscopic view was scored again using GVLw 
      (selected based on weight) and GVLs (1 size smaller than GVLw) in random order by 
      a single experienced anesthesiologist. All laryngoscopic views were graded both 
      with and without the backward, upward, and right lateral displacement of the 
      thyroid cartilage (BURP) maneuver. The primary outcome was the difference in the 
      C&L grade between DL and GVLw, and the secondary outcome was that between GVLw 
      and GVLs. For statistical analysis, the modified C&L grade was converted to an 
      ordinal scale. RESULTS: Data from 23 pediatric patients were analyzed. When 
      compared with DL, improvement of laryngoscopic view with the GVLw wa not obvious 
      (98.3% confidence interval [CI] for differences of ordinal scale, 0-1 without 
      BURP, P = 0.15 and 0-1 with BURP, P = 0.11). However, GVLs improved the 
      laryngoscopic view in comparison with both DL (98.3% CI for differences, 3.5-5.0 
      without BURP, P = 0.00007 and 3.5-4.5 with BURP, P = 0.0001) and GVLw (98.3% CI 
      for differences, 3.0-4.5 without BURP, P = 0.00007 and 2.5-4.0 with BURP, P = 
      0.0001). There was no adverse outcome during this study. CONCLUSIONS: In patients 
      with C&L grade >/=3 under direct laryngoscopy, GVLs significantly improved the 
      laryngoscopic view when compared with DL or GVLw. The GVLs is recommended for 
      improving the laryngoscopic view in patients with a difficult airway.
FAU - Lee, Ji-Hyun
AU  - Lee JH
AD  - Department of Anesthesiology and Pain Medicine, Seoul National University 
      Hospital, Daehak-ro 101, Jongno-gu, Seoul, 110-744, Republic of Korea. 
      kimjintae73@dreamwiz.com
FAU - Park, Yong-Hee
AU  - Park YH
FAU - Byon, Hyo-Jin
AU  - Byon HJ
FAU - Han, Woong-Ki
AU  - Han WK
FAU - Kim, Hee-Soo
AU  - Kim HS
FAU - Kim, Chong-Sung
AU  - Kim CS
FAU - Kim, Jin-Tae
AU  - Kim JT
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20130517
PL  - United States
TA  - Anesth Analg
JT  - Anesthesia and analgesia
JID - 1310650
SB  - IM
MH  - Adolescent
MH  - Airway Management/instrumentation/methods/*standards
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Infant
MH  - Intubation, Intratracheal/instrumentation/methods/*standards
MH  - Laryngoscopes/*standards
MH  - Laryngoscopy/instrumentation/methods/*standards
MH  - Male
MH  - Video-Assisted Surgery/instrumentation/methods/*standards
EDAT- 2013/05/21 06:00
MHDA- 2013/08/28 06:00
CRDT- 2013/05/21 06:00
PHST- 2013/05/21 06:00 [entrez]
PHST- 2013/05/21 06:00 [pubmed]
PHST- 2013/08/28 06:00 [medline]
AID - ANE.0b013e318292f0bf [pii]
AID - 10.1213/ANE.0b013e318292f0bf [doi]
PST - ppublish
SO  - Anesth Analg. 2013 Jul;117(1):176-81. doi: 10.1213/ANE.0b013e318292f0bf. Epub 
      2013 May 17.