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Canadian Journal of Anesthesia/Journal canadien d'anesthésie
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 12/2017

Open Access 01-12-2017 | Reports of Original Investigations

Randomized comparison of the effectiveness of nasal intubation using a GlideScope video laryngoscope with Magill forceps versus vascular forceps in patients with a normal airway

Authors: Jong H. Yeom, MD, PhD, Mi K. Oh, MD, Woo J. Shin, MD, PhD, Dae W. Ahn, MD, Woo J. Jeon, MD, PhD, Sang Y. Cho, MD, PhD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 12/2017

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Abstract

Purpose

The GlideScope® video laryngoscope (GVL) is widely used for nasotracheal intubation in dental and facial plastic surgery. The angle of the Magill forceps is different from that of the GVL blade, which suggests that the Magill forceps are not the ideal forceps for use with the GVL. The purpose of this study was to compare the effectiveness of the Magill forceps vs vascular forceps for nasotracheal intubation using the GVL.

Methods

This study included 60 patients scheduled to undergo elective surgery requiring nasotracheal intubation. Patients were assigned to one of two groups—i.e., Magill forceps (group M) or vascular forceps along with a tube exchanger (group V), by computer randomization. The primary outcome was total intubation time, defined as the time from when the anesthesiologist picked up the device to the time when three successive end-tidal CO2 waves were obtained following intubation. Secondary outcomes were blood in the endotracheal tube and trauma to the oral tissues or teeth. A blind observer assessed the presence of sore throat one hour and 24 hr after surgery.

Results

The total intubation time was significantly different between group M and group V (96.1 sec and 78.1 sec, respectively; mean difference, 18 sec; 95% confidence interval (CI), 13.7 to 49.7). The incidence of epistaxis in group M was significantly greater than that in group V (46.7% vs 16.7%, respectively; relative risk, 2.8; 95% CI, 1.2 to 6.8).

Conclusion

The total intubation time was significantly less with the vascular forceps (and tube exchanger) than with the Magill forceps. Using vascular forceps also reduced the incidence of epistaxis compared with that using the Magill forceps. Using a tube exchanger and vascular forceps offers advantages over use of Magill forceps when a GlideScope video laryngoscope is used for nasotracheal intubation.
Trial registration: http://​www.​who.​int/​ictrp/​network/​cris2/​en/​, CRIS, KCT0001310. Registered 29 July 2014.
Literature
1.
Jones PM, Armstrong KP, Armstrong PM, et al. A comparison of GlideScope videolaryngoscopy to direct laryngoscopy for nasotracheal intubation. Anesth Analg 2008; 107: 144-8.CrossRefPubMed
2.
Jeon WJ, Shim JH, Cho SY, Baek SJ. Stylet- or forceps-guided tube exchanger to facilitate GlideScope intubation in simulated difficult intubations–a randomised controlled trial. Anaesthesia 2013; 68: 585-90.CrossRefPubMed
3.
Salibian H, Jain S, Gabriel D, Azocar RJ. Conversion of an oral to nasal orotracheal intubation using an endotracheal tube exchanger. Anesth Analg 2003; 95: 1822.CrossRef
4.
Nakata Y, Niimi Y. Oral-to-nasal endotracheal tube exchange in patients with bleeding esophageal varices. Anesthesiology 1995; 83: 1380-1.CrossRefPubMed
5.
Niforopoulou P, Pantazopoulos I, Demestiha T, Koudouna E, Xanthos T. Video-laryngoscopes in adult airway management: a topical review of the literature. Acta Anaesthesiol Scand 2010; 54: 1050-61.CrossRefPubMed
6.
Liu EH, Goy RW, Tan BH, Asai T. Tracheal intubation with videolaryngoscopes in patients with cervical spine immobilization: a randomized trial of the AirwayScope and the GlideScope. Br J Anaesth 2009; 103: 446-51.CrossRefPubMed
7.
Lai HY, Chen IH, Chen A, Hwang FY, Lee Y. The use of the GlideScope for tracheal intubation in patients with ankylosing spondylitis. Br J Anaesth 2006; 97: 419-22.CrossRefPubMed
8.
Dupanovic M, Isaacson SA, Borovcanin Z, et al. Clinical comparison of two stylet angles for orotracheal intubation with the GlideScope video laryngoscope. J Clin Anesth 2010; 22: 352-9.CrossRefPubMed
9.
Moore MS, Wong AB. GlideScope intubation assisted by fiberoptic scope. Anesthesiology 2007; 106: 885.CrossRefPubMed
10.
Xue FS, Li CW, Zhang GH, et al. GlideScope-assisted awake intubation: initial experience in 13 patients. Anaesthesia 2006; 61: 1014-5.CrossRefPubMed
11.
Shim JH, Jeon WJ, Cho SY, Choe GH. Comparison of the GlideScope and the McGrath method using vascular forceps and a tube exchanger in case of simulated difficult airway intubation. Korean J Anesthesiol 2016; 69: 133-7.CrossRefPubMedPubMedCentral
12.
Hirabayashi Y. GlideScope videolaryngoscope facilitates nasotracheal intubation. Can J Anesth 2006; 53: 1163-4.CrossRef
13.
Xue F, Zhang G, Liu J, et al. A clinical assessment of the GlideScope videolaryngoscope in nasotracheal intubation with general anesthesia. J Clin Anesth 2006; 18: 611-5.CrossRefPubMed
14.
Kim YC, Lee SH, Noh GJ, et al. Thermosoftening treatment of the nasotracheal tube before intubation can reduce epistaxis and nasal damage. Anesth Analg 2000; 91: 698-701.CrossRefPubMed
15.
Lim CW, Min SW, Kim CS, Chung JE, Park JE, Hwang JY. The use of a nasogastric tube to facilitate nasotracheal intubation: a randomised trial. Anaesthesia 2014; 69: 591-7.CrossRefPubMed
16.
Seo KS, Kim JH, Yang SM, Kim HJ, Bahk JH, Yum KW. A new technique to reduce epistaxis and enhance navigability during nasotracheal intubation. Anesth Analg 2007; 105: 1420-4.CrossRefPubMed
17.
Enk D, Palmes AM, Van Aken H, Westphal M. Nasotracheal intubation: a simple and effective technique to reduce nasopharyngeal trauma and tube contamination. Anesth Analg 2002; 95: 1432-6.CrossRefPubMed
Metadata
Title
Randomized comparison of the effectiveness of nasal intubation using a GlideScope video laryngoscope with Magill forceps versus vascular forceps in patients with a normal airway
Authors
Jong H. Yeom, MD, PhD
Mi K. Oh, MD
Woo J. Shin, MD, PhD
Dae W. Ahn, MD
Woo J. Jeon, MD, PhD
Sang Y. Cho, MD, PhD
Publication date
01-12-2017
Publisher
Springer US
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 12/2017
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-017-0971-4

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