The GlideScope® video laryngoscope (GVL) is widely used for nasotracheal intubation in dental and facial plastic surgery. The angle of the Magill forceps is different from that of the GVL blade, which suggests that the Magill forceps are not the ideal forceps for use with the GVL. The purpose of this study was to compare the effectiveness of the Magill forceps vs vascular forceps for nasotracheal intubation using the GVL.
This study included 60 patients scheduled to undergo elective surgery requiring nasotracheal intubation. Patients were assigned to one of two groups—i.e., Magill forceps (group M) or vascular forceps along with a tube exchanger (group V), by computer randomization. The primary outcome was total intubation time, defined as the time from when the anesthesiologist picked up the device to the time when three successive end-tidal CO2 waves were obtained following intubation. Secondary outcomes were blood in the endotracheal tube and trauma to the oral tissues or teeth. A blind observer assessed the presence of sore throat one hour and 24 hr after surgery.
The total intubation time was significantly different between group M and group V (96.1 sec and 78.1 sec, respectively; mean difference, 18 sec; 95% confidence interval (CI), 13.7 to 49.7). The incidence of epistaxis in group M was significantly greater than that in group V (46.7% vs 16.7%, respectively; relative risk, 2.8; 95% CI, 1.2 to 6.8).
The total intubation time was significantly less with the vascular forceps (and tube exchanger) than with the Magill forceps. Using vascular forceps also reduced the incidence of epistaxis compared with that using the Magill forceps. Using a tube exchanger and vascular forceps offers advantages over use of Magill forceps when a GlideScope video laryngoscope is used for nasotracheal intubation.
Trial registration: http://www.who.int/ictrp/network/cris2/en/, CRIS, KCT0001310. Registered 29 July 2014.
Salibian H, Jain S, Gabriel D, Azocar RJ. Conversion of an oral to nasal orotracheal intubation using an endotracheal tube exchanger. Anesth Analg 2003; 95: 1822. CrossRef
Hirabayashi Y. GlideScope videolaryngoscope facilitates nasotracheal intubation. Can J Anesth 2006; 53: 1163-4. CrossRef
- Randomized comparison of the effectiveness of nasal intubation using a GlideScope video laryngoscope with Magill forceps versus vascular forceps in patients with a normal airway
MD, PhD Jong H. Yeom
MD Mi K. Oh
MD, PhD Woo J. Shin
MD Dae W. Ahn
MD, PhD Woo J. Jeon
MD, PhD Sang Y. Cho
- Springer US
Canadian Journal of Anesthesia/Journal canadien d'anesthésie
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
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