Comparison of Intubation Time with GlideScope® and McIntosh Laryngoscope in Obese Patients

Abstract

Background: Difficult intubation is more frequent in obese than in lean patients. The GlideScope® is a videolaryngoscope that provides a laryngoscopic view equal to or better than a direct laryngoscope in non-obese patients.

Objective: To compare the intubation time between the GlideScope® and the McIntosh laryngoscope in obese patients.

Material and method: The authors randomly allocated 46 obese patients (BMI >28 kg/m2) with the American Society of Anesthesiologists physical status I to III, scheduled for elective surgery under general anesthesia with oroendotracheal intubation into either the McIntosh group (Group M) or the GlideScope® group (Group G). The age range was 18 to 65 years old. Intubation was performed by anesthetic residents with experience in the use of the GlideScope® at least 10 times. The intubation time, the laryngoscopic view, the number of intubations and success rate, the number of optimizing maneuvers, vital signs, and complications from intubation were recorded.

Results: The intubation time in Group G (31 seconds) was not different from Group M (29 seconds). There was a significant difference in laryngoscopic view between the two groups. The laryngoscopic view was grade 2 in Group M and was grade 1 in Group G (p = 0.007). All patients in Group G were successfully intubated in the first attempt. There were two patients in Group M who needed more than one attempt. One of these needed a second intubation and another one was successful on the third attempt with the GlideScope®. However, there was no statistical significance in the overall success rate. The heart rate, blood pressure and complications were not statistically different.

Conclusion: The intubation time and the success rate between the McIntosh blade and GlideScope® in obese patients was not significantly different. Nevertheless, the GlideScope® provided a better laryngoscopic view than the McIntosh blade.