Comparison of videolaryngoscopy (Glidescope®) and direct laryngoscopy for tracheal intubation for cesarean section

Aim: The aim of this study was to retrospectively investigate the perioperative features and clinical outcomes in cesarean section (C/S) patients who underwent endotracheal intubation using direct laryngoscopy and Glidescope (R) videolaryngoscopy (GSVL). Material and Methods: This retrospective study was performed using data gathered from the medical files of 179 C/S patients who underwent C/S under general anesthesia. After the induction of anesthesia with intravenous injection of propofol 2 mg/kg, and vecuronium 0.1 mg/kg, orotracheal intubation was performed using either direct laryngoscopy or GSVL. The patients underwent C/S after endotracheal intubation using either direct laryngoscopy or GSVL. Group I (n=47) was intubated via direct laryngoscopy, while Glidescope (R) was used in Group II (n=132). Results: Baseline descriptives, craniofacial morphological measurements, duration of intubation and number of attempts for intubation, Cormack Lehane and Mallampati scores, as well as hemodynamic and respiratory parameters including blood pressure, heart rate, oxygen, and carbon dioxide levels were compared between two groups. The interincisal mouth opening (p=0.003) and CO2 levels (p=0.023) were increased in Group II. In Group I, the number of patients with protruding front teeth was higher than that in Group II (p=0.043). Discussion: Our results demonstrated that the GSVL could be a safe, effective, and practical device for endotracheal intubation in patients scheduled for C/S. Our data imply that GSVL can be incorporated into routine clinical practice in obstetric anesthetic practice for C/S since it allows improved visualization of the larynx in pregnants without bringing any significant burden.