Double-Lumen Tube Tracheal Intubation in Patients with Difficult Airway Using Disposcope Endoscope: a Randomized Controlled Comparison with GlideScope

Xuan Luo

Department of Thoracic and Cardiovascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China

Date, time and location: 2018.05.26 13:30, Press Hall, 2F

Abstract

Objective: Video-assisted laryngoscopes(VLs) such as GlideScope video laryngoscope(GVL) can improve the view of the glottis and increase the intubation success rate. There is lack of comparison study on VLs in patients with difficult airway. We evaluated the clinical application of Disposcope endoscope (DE) and compared the efficacy of GVL and DE in double-lumen tube（DLT） intubation in patients with difficult airway.

Methods: 606 patients scheduled for elective thoracic surgery needing DLT were studied. Patients who failed direct laryngoscope (DL) were randomly assigned into GVL and DE group (n =20 each) and intubated with GVL and DE, respectively. The causes of difficult intubation were analyzed.

Results: DE improved Cormack and Lehane (C&L) view in all patients and led to almost hundred percent success rate of intubation. GVL caused significant elevation of heart rate (HR) and blood pressure (BP) than DE (P<0.05). There was no difference in intubation time between GVL and DE. There were more intubation related injuries with GVL than DE.

Conclusions:GVL improves C&L view of patients with difficult airway due to anterior larynx and floppy epiglottis but not with small mouth opening, overbite and tall incisors. DE is more reliable intubation tool than GVL placing DLT in patients with difficult intubation. DE maybe a better intubation video scope for patients with unstable neck or needing tighter hemodynamic control.