Airway management in children with cervical spine may make direct laryngoscopy difficult. Video laryngoscopy is an alternative to direct laryngoscopy. The GlideScope video laryngoscope, successfully used in expected and unexpected difficult pediatric airway situations, has not been studied so far in children with cervical spine immobilization.
A total of 23 children underwent laryngoscopy with manual cervical spine immobilization using the GlideScope and a direct laryngoscope (Miller 1 or Macintosh 2 blade). Percentage of glottis opening score, Cormack-Lehane score, and time to best view were recorded.
Percentage of glottis opening score using the GlideScope was 50% (1%–87%) and 90% (60%–100%) using direct laryngoscopy (P < 0.001). Cormack-Lehane score using the GlideScope was 1 (1–2.7) and 1 (1–1) in direct laryngoscopy (P < 0.001). Time to best view with the GlideScope was 21 seconds (12.2–28 seconds) and 7 seconds (6–8.7 seconds) in direct laryngoscopy (P < 0.05). Data are presented as median and interquartile range and analyzed using paired t test.
In simulated difficult pediatric airway, using the GlideScope resulted in a significantly declined view to the glottic entrance. This result is in contrast to studies in children with difficult airway anatomy due to an anterior larynx, where the GlideScope resulted in improved views.
From the Departments of *Pediatric Anesthesia, and †Pediatric Critical Care, IWK Health Centre, and ‡Department of Anesthesia, Dalhousie University, Halifax, Nova Scotia, Canada.
Disclosure: The authors declare no conflict of interest.
Reprints: Arnim Vlatten, MD, Department of Pediatric Anesthesia and Department of Pediatric Critical Care, IWK Health Centre, 5850/5980 University Ave, PO Box 9700, Halifax, Nova Scotia B3K 6R8, Canada (e-mail email@example.com).
This study was funded from departmental resources.