Abstract:
Background: Direct laryngoscopy necessitates the alignment of the oropharyngeallaryngeal axis whereas video laryngoscope is an optical vision which doesn’t require
alignment. This study aimed to compare direct laryngoscopy with a Macintosh blade
to King-Vision Video laryngoscope for endotracheal intubation in patients who were
scheduled for elective laproscopic surgeries under general anaesthesia.
Methods: In this prospective randomised clinical study,118 adults with ASA I and II
requiring endotracheal intubation for laproscopic surgeries under general anaesthesia
were enrolled and randomised into either of the two groups by envelope method,
Group DL-direct laryngoscope and Group VL-video laryngoscope where they were
intubated using direct laryngoscope with Macintosh blade or King Vision
videolaryngoscope. The Primary objective was to compare Time to intubate(TTI),
Visualization of the laryngeal view by Cormack-Lehane grade and Successful first
attempt. Secondary objective was to record the Number of intubation failure, Number
of attempts, Change of anaesthesiologist and use of adjunct equipment and the
complications such as oropharyngeal trauma, neck pain, dysphagia and hoarseness.
Results: In comparison to group DL (21.67±4.318s), group VL took longer time to
intubate (26.21± 4.150s) but had superior glottic vision than DL group(p=0.0177).
Compared to DL group (72.4%), the VL (84.5%) patients had their first successful
attempt, inspite of 2 failures. Complications such as pharyngeal pain (8.6%vs29.3%),
hoarseness (5.2%vs29.3%), Use of adjunct equipment like bougie (19%vs 3.4%)
were significantly higher in DL compared to VL group, while oropharyngeal injury,
dysphagia, number of attempts and change of anaesthetists were similar in both
groups.
Conclusion: In comparison to the Macintosh laryngoscope, the King-vision
VideoLaryngoscope took longer to intubate but had clearer glottis visualisation and
a higher first-time success rate and can be used as a good teaching tool. In Kingvision video laryngoscope, there was less use of auxiliary equipment and fewer
complications.
