title: Measurement of forces applied during Macintosh direct laryngoscopy compared with GlideScope® videolaryngoscopy.
abstract: Laryngoscopy can induce stress responses that may be harmful in susceptible patients. We directly measured the force applied to the base of the tongue as a surrogate for the stress response. Force measurements were obtained using three FlexiForce Sensors(®) (Tekscan Inc, Boston, MA, USA) attached along the concave surface of each laryngoscope blade. Twenty-four 24 adult patients of ASA physical status 1-2 were studied. After induction of anaesthesia and neuromuscular blockade, laryngoscopy and tracheal intubation was performed using either a Macintosh or a GlideScope(®) (Verathon, Bothell, WA, USA) laryngoscope. Complete data were available for 23 patients. Compared with the Macintosh, we observed lower median (IQR [range]) peak force (9 (5-13 [3-25]) N vs 20 (14-28 [4-41]) N; p = 0.0001), average force (5 (3-7 [2-19]) N vs 11 (6-16 [1-24]) N; p = 0.0003) and impulse force (98 (42-151 [26-444]) Ns vs 150 (93-207 [17-509]) Ns; p = 0.017) with the GlideScope. Our study shows that the peak lifting force on the base of the tongue during laryngoscopy is less with the GlideScope videolaryngoscope compared with the Macintosh laryngoscope.
authors.affiliation: Department of Anesthesia, Toronto General Hospital, University of Toronto, Toronto, Canada. twainrussell@gmail.com
authors.forename: T
authors.initials: T
authors.lastname: Russell
authors.forename: S
authors.initials: S
authors.lastname: Khan
authors.forename: J
authors.initials: J
authors.lastname: Elman
authors.forename: R
authors.initials: R
authors.lastname: Katznelson
authors.forename: R M
authors.initials: RM
authors.lastname: Cooper
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000502:physiology; D011312:Pressure; D014059:Tongue / Q000502:physiology; D016896:Treatment Outcome; D014741:Video Recording