Feasibility and outcome of GlideScope videolaryngoscope versus C-MAC videolaryngoscope in the management of obese patients with potentially difficult intubation

Abstract

Background Difficult and failed tracheal intubation remains a leading cause of morbidity and mortality related to anesthesia practice. Videolaryngoscopes were introduced into practice to increase the success rate of intubation in obese patients with difficult airway. Aim The aim of this study was to compare GlideScope and C-MAC videolaryngoscopes in obese patients with anticipated difficult intubation as regards feasibility and outcome. Patients and methods The study was designed as a prospective comparative single-blind study, which was conducted at King Abdullah Hospital, Bisha, KSA, during the period from January 2013 to January 2015. It included 60 obese patients with anticipated difficult intubation. They were randomly divided into two equal groups: the GlideScope group and the C-MAC group. All patients were assessed for demographic characteristics, intubation parameters, and outcome. Results There were no significant differences between the two groups as regards general characteristics and hemodynamics. However, there was a significantly better glottic view in the GlideScope group compared with the C-MAC group. There was a significantly shorter total intubation time and first attempt intubation time in the GlideScope group compared with the C-MAC group (32.43±2.40 and 28.70±2.15 s vs. 40.40±5.07 and 34.80±2.92 s, respectively). The incidence of failure of the first intubation attempt was significantly higher in the C-MAC group compared with the GlideScope group (33.3 vs. 10.0%, respectively). Overall satisfaction was significantly better in the GlideScope group compared with the C-MAC group. Conclusion GlideScope had better glottic view, shorter total intubation and first attempt intubation times, and higher success rate of first intubation attempt compared with C-MAC. These results advocate the use of GlideScope in obese patients with potentially difficult intubation.