title: Tracheal intubation in patients immobilized by a rigid collar: a comparison of GlideScope and an intubating laryngeal mask airway.
abstract: OBJECTIVE
  Intubation must be rapidly performed with the utmost care in cervical trauma patients. We present the first comparison of GlideScope and an intubating laryngeal mask airway (ILMA) regarding insertion and intubation times, intubation success rates, mucosal damage, need for optimization maneuvers, effects on hemodynamic changes, and postoperative minor complications in a simulated cervical injury with a Philadelphia cervical collar.
  
  
  METHODS
  Ethics committee approval and patient consent were obtained and 94 American Society of Anesthesiology physical status I or II patients were enrolled in this study. Following standard anesthesia monitoring and induction, the Philadelphia-type cervical collar was applied and patients were subsequently intubated with ILMA or GlideScope.
  
  
  RESULTS
  The total intubation success rates were similar between the groups (96%). The insertion (14.9 ± 10 s vs. 21.9 ± 6.5 s, respectively; P < 0.001) and intubation (43.5 ± 13 s vs. 48.4 ± 11 s; P = 0.02) times for ILMA were longer than for GlideScope. The total intubation times for ILMA were longer than the intubation time for GlideScope (43.5 ± 13 s vs. 85.6 ± 13 s; P < 0.001). The mucosal damage was higher in the ILMA group (P = 0.04). The two airway devices increased the heart rate and mean arterial pressure after insertion compared with the postinduction values within groups.
  
  
  CONCLUSIONS
  GlideScope is superior to ILMA in terms of lower insertion and intubation times and lower levels of mucosal damage in cervical collar-immobilized patients.
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Semih
authors.initials: S
authors.lastname: Özdil
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Zehra İpek
authors.initials: Zİ
authors.lastname: Arslan Aydın
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Zehra Nur
authors.initials: ZN
authors.lastname: Baykara
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Toker
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Zeynep Mine
authors.initials: ZM
authors.lastname: Solak
mesh_terms: D006439:Hemodynamics; D006801:Humans; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D009333:Neck
keywords: GlideScope; cervical collar; intubating laryngeal mask airway