Is Glidescope Videolaryngoscope Superior To Conventional Macintosh Laryngoscope For Tracheal Intubation? A Meta-analysis Of Clinical Randomized Controlled Trials

Objectives:The Glidescope videolaryngoscope favors to expose the glottis and manipulate easily.However, it is still controversy wheather Glidescope videolaryngoscope could shorten intubation time,increase the first attempt rate and improve haemodynamic findings or not. We carried out this systematic review and meta-analysis to compare the effects of Glidescope laryngoscope and Macintosh laryngoscope during intubation at different situations.Methods: Data was retrieved from Medline, Embase, the Cochrane register of controlled trials and a manual search of bibliographies. Primary outcomes includes: the intubation time and the first attempt success rate. Secondary outcomes were the intubation difficulty scale(IDS) score,haemodynamic findings and the complications.Results: The Glidescope reduced the nasotracheal intubation time(Mean Difference,-13.91s; 95% CI,-23.60 s to-4.22s) but prolonged the intubation time in paediatric intubation(Mean Difference, 7.64s; 95% CI, 2.78 s to 12.50s) and orotracheal intubation(Mean Difference,8.75s;95%CI,3.62 s to 13.89s).It improved the first attempt success rate of orotracheal intubation in abnormal airways(Relative Risk, 3.70; 95% CI, 1.81 to 7.54) and in novice operators(Relative Risk, 7.88; 95% CI, 2.95 to 21.07). The Glidescope also provided a better condition for tracheal intubation,but couldn’t decrease the occurrence of hemodynamic fluctuations and complications.Conclusions: We conclude that the Glidescope videolaryngoscope could improve the explosure of the glottis but not decrease the hemodynamic fluctuations, paediatric or oraltracheal intubation time and complication.And it is more suitable for novice or predicted difficult airways and it is more efficient for adult nasotracheal intubations.