The investigators evaluated the usefulness of the Glidescope(GVL) compared with direct laryngoscopy in patients whose airway management are anticipated difficult (C\&L grade ≥3) by comparing the laryngoscopic view. Also, the investigators compared the effectiveness of smaller-size blade of GVL (GVLs) with standard blade of GVL selected by patient's weight (GVLw) in the same patients.
We assumed that smaller sized GVL can slide more angulated along the tongue, so the tip of a blade can be placed more anterior and cephalad. The angle of camera would be optimized by inserting the blade further with the blade tip directed toward the larynx. This optimization may be more remarkable with smaller blade because it can be inserted with rotation. Furthermore, the location and the angle of camera are different according to GVL blade size. Considering that patient with difficult airway has hypognathia and more cephalad larynx, it may be helpful with smaller sized GVL (GVLs) rather than GVL selected by weight (GVLw) for improvement of laryngoscopic view in patients with difficult airways. We hypothesized that GVLs can provide better laryngoscopic view than GVLw and DL in patient with difficult airway.
Study Type
INTERVENTIONAL
Allocation
NA
Masking
NONE
Enrollment
23
Glottis view assessment by direct visualization using Macintosh laryngoscope
Glottis view assessment by GVL selected by weight which is usually selected first
Glottis view assessment by GVL which is smaller in one size than GVL selected by age
The Differences in the Glottis View (C&L Grade) of Macintosh Laryngoscope and GVL Selected by Weight.
Glottis view was scored using C\&L grade by Macintosh laryngoscope and GVL selected by weight, and compared each other. We used modified C\&L grade: grade 1, all or most of the glottic aperture was visible; grade 2a, posterior cords and cartilage visible; grade 2b, only posterior cartilage visible; grade 3a, epiglottis visible and can be lifted; grade 3b, epiglottis adherent to the posterior pharynx; and grade 4, the epiglottis could not be visualized. For the statistical analysis, the modified C\&L grade was converted to an ordinal scale; grade 1 to 1, grade 2a to 2, grade 2b to 3, grade 3a to 4, grade 3b to 5, and grade 4 to 6. Therefore, score range for the data reported in the table was between 1 and 6, with 1 representing best view and 6 representing no view.
Time frame: up to 1 day of surgery
The Differences in the Glottis View (C&L Grade) of GVL Selected by Weight and Smaller Sized GVL
Glottis view was scored using C\&L grade by GVL selected by weight and smaller sized GVL, and compared each other. Score range for the data reported in the table was between 1 and 6, with 1 representing best view and 6 representing no view.
Time frame: up to 1day of surgery
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