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In this randomized clinical study, we compared the intubation success rates of the intubating laryngeal mask airway with the GlideScope® in patients with normal airways. The primary hypothesis was that the intubating laryngeal mask airway was equally effective as the GlideScope® in terms of successful intubation times.
Methods
Sixty ASA I and II adult patients undergoing elective gynaecological surgery were randomly allocated into either the intubating laryngeal mask airway group or the GlideScope® group. After a standard anaesthetic intravenous induction, orotracheal intubation was performed. Time taken for successful tracheal intubation, ease of device insertion, difficulty of tracheal intubation, manoeuvres needed to aid tracheal intubation, number of intubation attempts, haemodynamic changes every 2.5 min interval for 5 min and complications during tracheal intubation were recorded.
Results
Time to successful intubation was longer (mean 68.4 s ± 23.5 vs. 35.7 s ± 10.7; P < 0.05), mean difficulty score was higher (mean 16.7 ± 16.3 vs. 7.3 ± 13.1; P < 0.05) and more intubation attempts were required in the intubating laryngeal mask airway group.
Conclusion
The GlideScope® improved intubation time and difficulty score for tracheal intubation when compared with the intubating laryngeal mask airway in our patients. Blind intubation through the intubating laryngeal mask airway offers no advantages over the GlideScope® in patients with normal airways. Despite its limitations, the intubating laryngeal mask airway is a valuable adjunct, especially in cases of difficult airway management when it can provide ventilation in between intubation attempts.
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