Glidescope® video laryngoscope vs. Macintosh direct laryngoscope for the intubation of laryngeal neoplasm patients: a randomized controlled study

Background: Glidescope® video laryngoscope (GVL) is widely used in tracheal intubation. However, no studies have been conducted to compare the GVL and Macintosh direct laryngoscope (MDL) for intubation in patients with laryngeal neoplasm. Here, we aim to compare GVL and MDL for the intubation of laryngeal neoplasm patients. Methods: One hundred ninety-six American Society of Anesthesiology (ASA) physical status I and II adult patients were randomly assigned to either the GVL group (N=100) or the MDL group (N=96). Parameters such as the modified Cormack-Lehane grading, intubation complications, the visualization of neoplasm, the success rate, the percentage of external laryngeal manipulation (ELM) and the haemodynamic parameters were recorded in both groups. Results: The modified Cormack-Lehane grading (I/IIa/IIb/III/IV) was also significantly better in GVL than in MDL (57/31/12/0/0 vs. 27/23/46/4/0, respectively, P<0.001). Morever, the incidence of intubation complications in GVL was significantly lower than that in MDL (8% vs. 30%, respectively, P=0.002). The visualization of neoplasm in the GVL group was significantly superior to that in the MDL group (79% vs. 50%, respectively, P<0.001). The percentage of ELM in the GVL group was significantly lower than that in the MDL group (33% vs. 53%, respectively, P=0.006). The successful intubation rate on the first attempt and the haemodynamic changes didn’t differ between the groups. Conclusion: Our study indicated that GVL provided a close visualization of the neoplasm and allowed a full view of glottis. Therefore, its complications could be limited.