Comparison of video laryngoscopy and direct laryngoscopy during endotracheal intubation- A prospective comparative randomized study

Abstract

Direct laryngoscopy is most widely used method of oro-tracheal intubation but at times it could be difficult, and may lead to adverse effect on cardiovascular system. Video laryngoscopy in contrast provides better visualisation of airway making oro-tracheal intubation easy. The aim of this study was to prospectively compare the use of Video laryngoscope (Glidescope) versus the direct (Macintosch) laryngoscope blade for routine airway management A prospective randomised comparative study was done by randomly allocating patients undergoing elective surgery to one of two Groups comprising 50 patients in each as: Group I-indirect laryngoscope (Video) and Group D-Direct (Macintosh) laryngoscope. After induction patients were intubated according to group allotted. Ease of intubation and other haemodynamic parameters were recorded at numerous intervals as follow: baseline, after induction of anaesthesia, one and five minutes after intubation. Time required for the laryngoscopy and tracheal intubation in Group I i.e. indirect (18.50 seconds) was more as compared to Group D direct (11.76 seconds) with statistical significance. The Group I procedure significantly reduced tracheal intubation difficulty score and the ease of intubation was statistically insignificant as compared to that of Group D. It was found that there was a significantly better Modified Cormack Lehane Grade in Group I(100%) as compared to Group D(65%).Video laryngoscopy (Glidescope) is considered advantageous over conventional direct laryngoscope (Macintosh) in terms of lower intubation difficulty score (IDS), better ease of intubation and lower grades of Modified Cormack Lehane Grade with indirect laryngoscopy). It can be used as a teaching tool for novice intubators and offers a new approach to tracheal intubation.