Skip to main content
SpringerLink
Log in

Videolaryngoskopie olé!

Direkte und flexible Intubationsverfahren ade?

Video laryngoscopy olé!

Time to say good bye to direct and flexible intubation?

  • Leitthema
  • Published:
Der Anaesthesist Aims and scope Submit manuscript

Zusammenfassung

In den letzten Jahren haben verschiedene Videolaryngoskopiesysteme Einzug in die anästhesiologische Praxis gehalten. Aufgrund der technischen Konzeption dieser Systeme (stärker angulierte Spatelform bzw. nahe der Spatelspitze befindliche Kameraoptik) ist die Sicht auf die laryngealen Strukturen sowohl bei normalen als auch bei schwierigen Laryngoskopieverhältnissen häufig besser als bei der direkten Laryngoskopie. Gleichzeitig bietet die Visualisierung des Intubationsvorgangs gute Möglichkeiten in Ausbildung und Supervision. Mit der zunehmenden Verbreitung der Videolaryngoskopie könnten die direkte laryngoskopische und die flexible fiberoptische Intubation in den Hintergrund gedrängt werden. Dieser Beitrag beschreibt die aktuellen Entwicklungen und diskutiert, warum die Expertise in der direkten Laryngoskopie und in der Intubation mithilfe der flexiblen Fiberoptik trotz zunehmender Verbreitung der Videolaryngoskopie v. a. für Experten im Bereich der Atemwegssicherung aufrechterhalten werden sollte.

Abstract

A number of video laryngoscopy systems have been introduced into anesthetic practice in recent years. Due to the technical concepts of these systems exposure of the laryngeal structures is usually better than with direct laryngoscopy, both in normal airways as well as in those that are difficult to manage. With the increasing use of video laryngoscopy it seems as if direct laryngoscopy and flexible fibrescopic intubation are at risk of becoming redundant. This article describes current developments and discusses why expertise in direct laryngoscopy and flexible fibrescopic intubation should be maintained, particularly by experts in airway management. The English full text version of this article is available in SpringerLink (under “Supplemental”).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5

Literatur

  1. Agrò F, Barzoi G, Montecchia F (2003) Tracheal intubation using a Macintosh laryngoscope or a GlideScope in 15 patients with cervical spine immobilization. Br J Anaesth 90:705–706

    Article  PubMed  Google Scholar 

  2. Andersen LH, Rovsing L, Olsen KS (2011) Glidescope videolaryngoscope vs. Macintosh direct laryngoscope for intubation of morbidly obese patients: a randomized trial. Acta Anaesthesiol Scand 55:1090–1097

    Article  PubMed  CAS  Google Scholar 

  3. Armstrong J, John J, Karsli C (2010) A comparison between the GlideScope Video Laryngoscope and direct laryngoscope in paediatric patients with difficult airways – a pilot study. Anaesthesia 65:353–357

    Article  PubMed  CAS  Google Scholar 

  4. Asai T (2010) Pentax-AWS videolaryngoscope for awake nasal intubation in patients with unstable necks. Br J Anaesth 104:108–111

    Article  PubMed  CAS  Google Scholar 

  5. Asai T, Liu EH, Matsumoto S et al (2009) Use of the Pentax-AWS in 293 patients with difficult airways. Anesthesiology 110:898–904

    Article  PubMed  Google Scholar 

  6. Aziz MF, Healy D, Kheterpal S et al (2011) Routine clinical practice effectiveness of the Glidescope in difficult airway management: an analysis of 2,004 Glidescope intubations, complications, and failures from two institutions. Anesthesiology 114:34–41

    Article  PubMed  Google Scholar 

  7. Baciarello M, Zasa M, Manferdini ME et al (2012) The learning curve for laryngoscopy: Airtraq versus Macintosh laryngoscopes. J Anesth 26(4):516–524

    Article  PubMed  Google Scholar 

  8. Borland LM, Casselbrant M (1990) The Bullard laryngoscope. A new indirect oral laryngoscope (pediatric version). Anesth Analg 70:105–108

    Article  PubMed  CAS  Google Scholar 

  9. Brown CA III, Bair AE, Pallin DJ et al (2010) Improved glottic exposure with the video Macintosh laryngoscope in adult emergency department tracheal intubations. Ann Emerg Med 56:83–88

    Article  PubMed  Google Scholar 

  10. Bumm P (1992) Intubation aid by a rigid endoscope. Anasthesiol Intensivmed Notfallmed Schmerzther 27:279–285

    Article  PubMed  CAS  Google Scholar 

  11. Caldiroli D, Cortellazzi P (2011) A new difficult airway management algorithm based upon the El Ganzouri Risk Index and GlideScope® videolaryngoscope: a new look for intubation? Minerva Anestesiol 77:1011–1017

    PubMed  CAS  Google Scholar 

  12. Cavus E, Bein B, Dorges V (2011) Airwaymanagement: video-assisted airway management. Anasthesiol Intensivmed Notfallmed Schmerzther 46:588–596

    Article  PubMed  Google Scholar 

  13. Cavus E, Callies A, Doerges V et al (2011) The C-Mac videolaryngoscope for prehospital emergency intubation: a prospective, multicentre, observational study. Emerg Med J 28:650–653

    Article  PubMed  Google Scholar 

  14. Cavus E, Thee C, Moeller T et al (2011) A randomised, controlled crossover comparison of the C-Mac videolaryngoscope with direct laryngoscopy in 150 patients during routine induction of anaesthesia. BMC Anesthesiol 11:6

    Article  PubMed  Google Scholar 

  15. Cooper RM (2007) Complications associated with the use of the GlideScope videolaryngoscope. Can J Anaesth 54:54–57

    Article  PubMed  Google Scholar 

  16. Cooper RM (2003) Use of a new videolaryngoscope (GlideScope) in the management of a difficult airway. Can J Anaesth 50:611–613

    Article  PubMed  Google Scholar 

  17. Cortellazzi P, Minati L, Falcone C et al (2007) Predictive value of the El-Ganzouri multivariate risk index for difficult tracheal intubation: a comparison of Glidescope videolaryngoscopy and conventional Macintosh laryngoscopy. Br J Anaesth 99:906–911

    Article  PubMed  CAS  Google Scholar 

  18. Dalal PG, Dalal GB, Pott L et al (2011) Learning curves of novice anesthesiology residents performing simulated fibreoptic upper airway endoscopy. Can J Anaesth 58:802–809

    Article  PubMed  Google Scholar 

  19. DGAInfo (2011) Handlungsempfehlungen zur Prävention und Behandlung des unerwartet schwierigen Atemwegs in der Kinderanästhesie. Anaesth Intensivmed 54–63

  20. El-Ganzouri AR, McCarthy RJ, Tuman KJ et al (1996) Preoperative airway assessment: predictive value of a multivariate risk index. Anesth Analg 82:1197–1204

    PubMed  CAS  Google Scholar 

  21. El-Orbany M (2012) Will direct laryngoscopy become an extinct skill? Acta Anaesthesiol Scand 56:260

    Article  PubMed  CAS  Google Scholar 

  22. Erb T, Hampl KF, Schurch M et al (1999) Teaching the use of fiberoptic intubation in anesthetized, spontaneously breathing patients. Anesth Analg 89:1292–1295

    Article  PubMed  CAS  Google Scholar 

  23. Griesdale DE, Liu D, McKinney J, Choi PT (2011) Glidescope® video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysis. Can J Anaesth 59:41–52

    PubMed  Google Scholar 

  24. Henthorn RW, Reed J, Szafranski JS, Ganta R (1995) Combining the fiberoptic bronchoscope with a laryngoscope blade aids teaching direct laryngoscopy. Anesth Analg 80:427–734

    Google Scholar 

  25. Hofstetter C, Scheller B, Flondor M et al (2006) Videolaryngoscopy versus direct laryngoscopy for elective endotracheal intubation. Anaesthesist 55:535–540

    Article  PubMed  CAS  Google Scholar 

  26. Johnson C, Roberts JT (1989) Clinical competence in the performance of fiberoptic laryngoscopy and endotracheal intubation: a study of resident instruction. J Clin Anesth 1:344–349

    Article  PubMed  CAS  Google Scholar 

  27. Kaplan MB, Hagberg CA, Ward DS et al (2006) Comparison of direct and video-assisted views of the larynx during routine intubation. J Clin Anesth 18:357–362

    Article  PubMed  Google Scholar 

  28. Maassen R, Lee R, Zundert A van, Cooper R (2009) The videolaryngoscope is less traumatic than the classic laryngoscope for a difficult airway in an obese patient. J Anesth 23:445–448

    Article  PubMed  Google Scholar 

  29. Maharaj CH, Costello JF, Higgins BD et al (2006) Learning and performance of tracheal intubation by novice personnel: a comparison of the Airtraq and Macintosh laryngoscope. Anaesthesia 61:671–677

    Article  PubMed  CAS  Google Scholar 

  30. Malik MA, Subramaniam R, Maharaj CH et al (2009) Randomized controlled trial of the Pentax AWS, Glidescope, and Macintosh laryngoscopes in predicted difficult intubation. Br J Anaesth 103:761–768

    Article  PubMed  CAS  Google Scholar 

  31. Miller RA (1946) A new laryngoscope for intubation of infants. Anesthesiology 7:205

    Article  PubMed  CAS  Google Scholar 

  32. Moore AR, Schricker T, Court O (2012) Awake videolaryngoscopy-assisted tracheal intubation of the morbidly obese. Anaesthesia 67:232–235

    Article  PubMed  CAS  Google Scholar 

  33. Naik VN, Matsumoto ED, Houston PL et al (2001) Fiberoptic orotracheal intubation on anesthetized patients: do manipulation skills learned on a simple model transfer into the operating room? Anesthesiology 95:343–348

    Article  PubMed  CAS  Google Scholar 

  34. Nasim S, Maharaj CH, Malik MA et al (2009) Comparison of the Glidescope and Pentax AWS laryngoscopes to the Macintosh laryngoscope for use by advanced paramedics in easy and simulated difficult intubation. BMC Emerg Med 9:9

    Article  PubMed  Google Scholar 

  35. Noppens RR, Werner C, Piepho T (2010) Indirect laryngoscopy: alternatives to securing the airway. Anaesthesist 59:149–161

    Article  PubMed  CAS  Google Scholar 

  36. Nouruzi-Sedeh P, Schumann M, Groeben H (2009) Laryngoscopy via Macintosh blade versus Glidescope: success rate and time for endotracheal intubation in untrained medical personnel. Anesthesiology 110:32–37

    Article  PubMed  Google Scholar 

  37. Osborn IP, Behringer EC, Kramer DC (2007) Difficult airway management following supratentorial craniotomy: a useful maneuver with a new device. Anesth Analg 105:552–553

    Article  PubMed  Google Scholar 

  38. Rai MR, Popat MT (2011) Evaluation of airway equipment: man or manikin? Anaesthesia 66:1–3

    Article  PubMed  CAS  Google Scholar 

  39. Russell T, Khan S, Elman J et al (2012) Measurement of forces applied during Macintosh direct laryngoscopy compared with GlideScope® videolaryngoscopy. Anaesthesia 67:626–631

    Article  PubMed  CAS  Google Scholar 

  40. Russell T, Lee C, Firat M, Cooper RM (2011) A comparison of the forces applied to a manikin during laryngoscopy with the GlideScope and Macintosh laryngoscopes. Anaesth Intensive Care 39:1098–1102

    PubMed  CAS  Google Scholar 

  41. Saunders PR, Geiseke AH (1989) Clinical assessment of the adult Bullard laryngoscope. Can J Anaesth 36:119–120

    Google Scholar 

  42. Zundert A van, Maassen R, Lee R et al (2009) A Macintosh laryngoscope blade for videolaryngoscopy reduces stylet use in patients with normal airways. Anesth Analg 109:825–831

    Article  PubMed  Google Scholar 

  43. Zundert A van, Pieters B, Zundert T van, Gatt S (2012) Avoiding palatopharyngeal trauma during videolaryngoscopy: do not forget the „blind spots“. Acta Anaesthesiol Scand 56:532–634

    Article  PubMed  Google Scholar 

  44. Vincent RD Jr, Wimberly MP, Brockwell RC, Magnuson JS (2007) Soft palate perforation during orotracheal intubation facilitated by the glidescope videolaryngoscope. J Clin Anesth 19:619–621

    Article  PubMed  Google Scholar 

  45. Vlatten A, Aucoin S, Litz S et al (2009) A comparison of the Storz video laryngoscope and standard direct laryngoscopy for intubation in the pediatric airway – a randomized clinical trial. Paediatr Anaesth 19:1102–1107

    Article  PubMed  Google Scholar 

  46. Wahlen BM, Roewer N, Kranke P (2010) A survey assessing the procurement, storage and preferences of airway management devices by anaesthesia departments in German hospitals. Eur J Anaesthesiol 27:526–533

    PubMed  Google Scholar 

  47. Weiss M (1997) Management of difficult tracheal intubation with a video-optically modified Schroeder intubation stylet. Anesth Analg 85:1181–1182

    PubMed  CAS  Google Scholar 

  48. Weiss M (1998) Video-intuboscopy: a new aid to routine and difficult tracheal intubation. Br J Anaesth 80:525–527

    Article  PubMed  CAS  Google Scholar 

  49. Weiss M, Hartmann K, Fischer J, Gerber AC (2001) Video-intuboscopic assistance is a useful aid to tracheal intubation in pediatric patients. Can J Anaesth 48:691–696

    Article  PubMed  CAS  Google Scholar 

  50. Weiss M, Schwarz U, Gerber C (1998) Video-intubating laryngoscopy – A new concept for routine and difficult tracheal intubation management. Anesthesiology V98, No3A, September

  51. Weiss M, Hartmann K, Fischer JE, Gerber AC (2001) Use of angulated video-intubation laryngoscope in children undergoing manual in-line neck stabilization. Br J Anaesth 87:453–458

    Article  PubMed  CAS  Google Scholar 

  52. Weiss M, Mauch J, Becke K et al (2009) Fibre optic-assisted endotracheal intubation through the laryngeal mask in children. Anaesthesist 58:716–721

    Article  PubMed  CAS  Google Scholar 

  53. Weiss M, Schwarz U, Dillier CM, Gerber AC (2001) Teaching and supervising tracheal intubation in paediatric patients using videolaryngoscopy. Paediatr Anaesth 11:343–348

    Article  PubMed  CAS  Google Scholar 

  54. Weiss M, Schwarz U, Dillier CM, Gerber AC (2000) Video-intuboscopic monitoring of tracheal intubation in pediatric patients. Can J Anaesth 47:1202–1206

    Article  PubMed  CAS  Google Scholar 

  55. Xue FS, Xiong J, Yuan YJ et al (2010) Pentax-AWS videolaryngoscope for awake nasotracheal intubation in patients with a difficult airway. Br J Anaesth 104:50

    Article  Google Scholar 

Download references

Interessenkonflikt

Keine Angaben

Author information

Authors and Affiliations

  1. Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland

    S.G. Russo D.E.A.A.

  2. Anästhesieabteilung, Universitäts-Kinderkliniken, Zürich, Schweiz

    M. Weiss

  3. Abteilung Anästhesie, Kinderintensiv- und Notfallmedizin, Kinder- und Jugendkrankenhaus auf der Bult, Hannover, Deutschland

    C. Eich D.E.A.A., FERC

Authors
  1. S.G. Russo D.E.A.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Eich D.E.A.A., FERC
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S.G. Russo D.E.A.A..

Zusatzmaterial online

Rights and permissions

Reprints and permissions

About this article

Cite this article

Russo, S., Weiss, M. & Eich, C. Videolaryngoskopie olé!. Anaesthesist 61, 1017–1026 (2012). https://doi.org/10.1007/s00101-012-2110-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00101-012-2110-5

Schlüsselwörter

Keywords

Search

Navigation