Endotracheal intubation in elective cervical surgery

BACKGROUND We compared the effectiveness and safety of endotracheal intubation using the GlideScope (GS) video laryngoscope, CTrach laryngeal mask airway (LMA), or Shikani optical stylet rigid laryngoscope (SOS) during elective cervical surgery. METHODS Forty-five patients undergoing elective cervical surgery were randomly and equally assigned to endotracheal intubation via GS, LMA, or SOS airway management. RESULTS Endotracheal intubation was successfully completed in all patients. The mean intubation times of the groups differed significantly (P < .01): GS, 17.9 ± 3.1 s; SOS, 40.4 ± 13.7 s; and LMA, 80.5 ± 22.5 s. The groups had similar heart rates and mean arterial pressures throughout the intubation, except that at 2 minutes after intubation the mean arterial pressure of the GS group (106.1 ± 18.5 mm Hg) was significantly higher than that of the LMA (89.7 ± 18.5 mm Hg) or SOS (89.7 ± 18.5 mm Hg; P < .01). The change in C2-5 Cobb angle from baseline was significantly higher in the GS group (GS, 34.2° ± 7.3°) than the LMA (24.4° ± 5.8°) or SOS (25.5° ± 6.4°); P < .01). CONCLUSIONS The CTrach LMA and SOS rigid laryngoscope are effective, safe alternatives to the GS video laryngoscope for patients undergoing elective cervical surgery.