Vol. 6, Issue 1, Part A (2024)

Background & Aims: The inability to manage difficult airways results in morbidity and mortality from hypoxic brain injury and attributes to 30% of deaths that occur under general anesthesia. Video laryngoscopes (VL) used to mitigate them have become a part of difficult airway carts. We compare the performance and outcomes of King Vision video laryngoscope (KVVL) with Macintosh direct laryngoscope (MDL) for endotracheal intubation in patients requiring general anesthesia for elective surgery.

Materials & Methods: This comparative study randomized 126 patients under general anaesthesia in two groups: KVVL and MDL (n = 63; n = 63). An airway assessment was performed on all patients. The primary endpoint was the ease of intubation measured as the number of attempts, time, and manipulation required for intubation, and the laryngeal view obtained. The secondary endpoints were hemodynamic response and airway morbidities.

Results: The KVVL group had a better first pass success rate (100% vs 93.7%, p<0.05), less time (10.9±2.1 vs. 16.1±3.26 seconds, p<0.001) and lesser manipulation (3.2% vs. 19%, p<0.001) required for intubation compared to the MDL group. The KVVL group showed an improved glottic visualization measured in terms of CL grading compared with the MDL group (p<0.001). The KVVL group had lesser hemodynamic response one-minute post-intubation in terms of pulse rate (p<0.05) and blood pressure (p<0.001), whereas airway morbidities observed were almost similar (p=0.3).

Conclusion: The performance and outcomes of KVVL in intubating patients for general anaesthesia by experienced operators were more promising with fewer airway complications compared with MDL.