ORIGINAL ARTICLE
Tracheal intubation with GlideScope vs. Sanyar video laryngoscopes in adults with predicted difficult intubation: a non-inferiority clinical trial
1
Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran
2
Department of Anesthesia and Critical Care, Sina Hospital, Faculty of Medicine Tehran University of Medical Sciences, Tehran, Iran
3
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Submission date: 2024-02-13
Final revision date: 2024-09-10
Acceptance date: 2025-01-19
Publication date: 2025-05-27
Corresponding author
Mohamadreza Neishaboury
Department of Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran
Anaesthesiol Intensive Ther 2025;57(1):80-86
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Maintaining control over the airway is critical during general anesthesia induction, particularly in patients with anticipated difficult airways. Video laryngoscopy with various devices has emerged as a valuable tool in such scenarios and has shown promising performance. This study aimed to evaluate glottic visualization and the first attempt success rate of tracheal intubation of GlideScope and Sanyar video laryngo- scopes in adult patients with predicted difficult intubation.
Material and methods:
A randomized, controlled, two-armed, parallel clinical trial was conducted, in adult patients with anticipated difficult intubation undergoing elective surgery under general anesthesia. Participants were randomly assigned to either the GlideScope or Sanyar group. The primary outcome was the success rate of intubation in the first attempt at laryngoscopy, and secondary outcomes were the duration of intubation, glottic visualization, blood pressure and heart rate after intubation.
Results:
A total of 93 patients were included in the analysis, with 46 in the S group and 47 in the G group. The S group demonstrated a significantly higher first-attempt success rate of tracheal intubation (93.4% vs. 85.2%; P = 0.002) and shorter intubation time (29.28 ± 8.00 seconds vs. 42.73 ± 15.50 seconds; P = 0.0001) compared to the G group. Glottic visualization and hemodynamic changes did not significantly differ between the two groups.
Conclusions:
The Sanyar video laryngoscope exhibited superior efficacy in terms of first-attempt tracheal intubation success and shorter intubation time compared to the GlideScope in adult patients with predicted difficult airways. These findings suggest that the Sanyar video laryngoscope may serve as a valuable alternative in challenging intubation scenarios.
Maintaining control over the airway is critical during general anesthesia induction, particularly in patients with anticipated difficult airways. Video laryngoscopy with various devices has emerged as a valuable tool in such scenarios and has shown promising performance. This study aimed to evaluate glottic visualization and the first attempt success rate of tracheal intubation of GlideScope and Sanyar video laryngo- scopes in adult patients with predicted difficult intubation.
Material and methods:
A randomized, controlled, two-armed, parallel clinical trial was conducted, in adult patients with anticipated difficult intubation undergoing elective surgery under general anesthesia. Participants were randomly assigned to either the GlideScope or Sanyar group. The primary outcome was the success rate of intubation in the first attempt at laryngoscopy, and secondary outcomes were the duration of intubation, glottic visualization, blood pressure and heart rate after intubation.
Results:
A total of 93 patients were included in the analysis, with 46 in the S group and 47 in the G group. The S group demonstrated a significantly higher first-attempt success rate of tracheal intubation (93.4% vs. 85.2%; P = 0.002) and shorter intubation time (29.28 ± 8.00 seconds vs. 42.73 ± 15.50 seconds; P = 0.0001) compared to the G group. Glottic visualization and hemodynamic changes did not significantly differ between the two groups.
Conclusions:
The Sanyar video laryngoscope exhibited superior efficacy in terms of first-attempt tracheal intubation success and shorter intubation time compared to the GlideScope in adult patients with predicted difficult airways. These findings suggest that the Sanyar video laryngoscope may serve as a valuable alternative in challenging intubation scenarios.
REFERENCES (15)
1.
Gómez-Ríos MA, Sastre JA, Onrubia-Fuertes X, López T, Abad-Gurumeta A, Casans-Francés R, et al. Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR), Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) guideline for difficult airway management. Part I. Rev Esp Anestesiol Reanim (Engl Ed) 2024; 71: 171-206. DOI: https://doi.org/10.1016/ J.REDAR.2023.08.002.
2.
Khan ZH, Rahimi M, Atabi T. Anticipated and unanticipated difficult airway: a practical and logical approach: a narrative review. Arch Anesth Crit Care 2018; 4: 505-508.
3.
Etezadi F, Saeedinia L, Pourfakhr P, Najafi A, Khajavi M, Ahangari A, Shariat Moharari R. Comparison of four methods for predicting difficult laryngoscopy: a prospective study of validity indexes. Arch Anesth Crit Care 2018; 4: 483-487. DOI: 10.20935/AcadBiol7491.
4.
Shruthi AH, Dinakara D, Chandrika YR. Role of videolaryngoscope in the management of difficult airway in adults: a survey. Indian J Anaesth 2020; 64: 855. DOI: 10.4103/ija.IJA_211_20.
5.
Pieters BM, Maas EH, Knape JT, Van Zundert AA. Videolaryngoscopy vs. direct laryngoscopy use by experienced anaesthetists in patients with known difficult airways: a systematic review and meta‐analysis. Anaesthesia 2017; 72: 1532-1541. DOI: 10.1111/anae.14057.
6.
Kleine-Brüggeney M, Greif R, Schoettker P, Savoldelli GL, Nabecker S, Theiler LG. Evaluation of six videolaryngoscopes in 720 patients with a simulated difficult airway: a multicentre randomized controlled trial. Br J Anaesth 2016; 116: 670-679. DOI: 10.1093/bja/aew058.
7.
Gómez-Ríos MÁ, Sastre JA, Onrubia-Fuertes X, López T, Abad- Gurumeta A, Casans-Frances R, et al. Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR), Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) Guideline for difficult airway management. Part II. Rev Esp Anestesiol Reanim (Engl Ed) 2024; 71: 207-247. DOI: 10.1016/j.redare.
8.
Khajavi MR, Mohammadyousefi R, Neishaboury M, Moharari RS, Etezadi F, Pourfakhr P. Early clinical experience with a new video laryngoscope (SANYAR) for tracheal intubation in adults: a comparison clinical study. Front Emerg Med 2022; 6: e35. DOI: 10.18502/fem.v6i3.9397.
9.
Khajavi MR, Ramezani R, Sharifnia HR, Najafi A, Barkhordari K. Sanyar Video laryngoscope improved time and first pass success of tracheal intubation in intensive care unit in compared to direct laryngoscopy. Arch Anesth Crit Care 2023; 9. DOI: https://doi.org/ 10.18502/aacc.v9i3.13111.
10.
Etezadi F, Ahangari A, Shokri H, Najafi A, Khajavi MR, Daghigh M, Moharari RS. Thyromental height: a new clinical test for prediction of difficult laryngoscopy. Anesth Analg 2013; 117: 1347-1351. DOI: 10.1213/ANE.0b013e3182a8c734.
11.
Krobbuaban B, Diregpoke S, Kumkeaw S, Tanomsat M. The predictive value of the height ratio and thyromental distance: four predictive tests for difficult laryngoscopy. Anesth Analg 2005; 101: 1542-1545. DOI: 10.1213/01.ANE.0000181000.43971.1E.
12.
Mazzinari G, Rovira L, Henao L, Ortega J, Casasempere A, Fernandez Y, et al. Effect of dynamic versus stylet-guided intubation on first- attempt success in difficult airways undergoing glidescope laryngoscopy: a randomized controlled trial. Anesth Analg 2019; 128: 1264-1271. DOI: 10.1213/ANE.0000000000004102.
13.
Ibinson JW, Ezaru CS, Cormican DS, Mangione MP. GlideScope use improves intubation success rates: an observational study using propensity score matching. BMC Anesthesiol 2014; 14: 101. DOI: 10.1186/1471-2253-14-101.
14.
Hoshijima H, Mihara T, Denawa Y, Shiga T, Mizuta K. Airtraq versus GlideScope for tracheal intubation in adults: a systematic review and meta-analysis with trial sequential analysis. Can J Anesth 2022; 69: 605-613. DOI: 10.1007/s12630-022-02217-0.
15.
Cortellazzi P, Caldiroli D, Byrne A, Sommariva A, Orena EF, Tramacere I. Defining and developing expertise in tracheal intubation using a GlideScope for anaesthetists with expertise in Macintosh direct laryngoscopy: an in‐vivo longitudinal study. Anaesthesia 2015; 70: 290-295. DOI: 10.1111/anae.12878.
Share
RELATED ARTICLE
| eISSN: | 1731-2531 |
| ISSN: | 1642-5758 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
