A prospective randomized comparative study between Macintosh and GlideScope in adult patients undergoing cardiac surgery

Abstract

Context The GlideScope laryngoscope is a new device for intubation that provides an improved view of the larynx. Aim The aim of the study was to compare the hemodynamic effect of Macintosh laryngoscope with GlideScope during intubation in adult cardiac surgery. Setting and design This was a prospective, randomized, comparative study conducted in Madinah Cardiac Center, Saudi Arabia. Materials and methods The study included 100 patients classified into two groups (n = 50), The patients were intubated either by Macintosh laryngoscope or by GlideScope. The following parameters were monitored: heart rate, mean arterial blood pressure, catecholamine level, intubation time, number of intubation trials, and the complications. Statistical analysis used Data were statistically described in terms of mean ΁ SD or frequencies. Measurements and main results The intubation time was longer in GlideScope than in Macintosh (P < 0.001), and the number of intubation trials was higher in GlideScope than in Macintosh (P < 0.001). The heart rate increased significantly in patients of the GlideScope group compared with the Macintosh group at first minute (P < 0.001), third minute (P < 0.001), and at fifth minute (P = 0.034). The mean arterial blood pressure increased significantly in patients of the GlideScope group compared with the Macintosh group at first minute (P < 0.001), third minute (P = 0.003), and at fifth minute (P = 0.029). The epinephrine level was higher with GlideScope at first and fifth minute (P = 0.032 and 0.036, respectively). The norepinephrine was higher in the GlideScope group at first and fifth minute (P = 0.043 and 0.033, respectively). The incidence of oral trauma and bleeding was higher with GlideScope than Macintosh (P = 0.003). Conclusion The intubation by GlideScope is associated with increased heart rate, blood pressure, catecholamine level, number of intubation trials, and oral complications compared with Macintosh laryngoscope.