KING VISION™ VIDEOLARYNGOSCOPE VERSUS MACINTOSH LARYNGOSCOPE: A META-ANALYSIS FOCUSED ON APPLICABILITY IN DEVELOPING COUNTRIES

Objective: To compare the clinical effectiveness of the King Vision™ low-cost videolaryngoscope with the traditional Macintosh laryngoscope in orotracheal intubation, focusing on its applicability in resource-limited settings. Methods: This systematic review and meta-analysis followed PRISMA guidelines. Searches were conducted in PubMed, LILACS, Scopus, and EMBASE (2020–2025). Included studies were randomized controlled trials and comparative observational studies evaluating King Vision™ versus Macintosh in clinical settings. Outcomes included first-attempt intubation success, time to intubation, complications, and cost considerations. Risk of bias was assessed using RoB 2.0 and ROBINS-I tools. Results: Four studies with 348 patients were included. The King Vision™ showed a trend toward higher first-attempt success (RR 1.10; 95% CI: 0.99–1.22; p = 0.08), though not statistically significant. Time to intubation was longer with videolaryngoscopy (mean difference: +11.53 seconds; 95% CI: +7.00 to +16.05; p < 0.001). All studies reported better glottic visualization with videolaryngoscopes, supported by improved Cormack-Lehane grades and glottic opening scores. Serious complications were rare, and the need for rescue maneuvers was reduced. Most studies had low or moderate risk of bias. King Vision™ demonstrated economic advantages, with significantly lower cost than high-end devices and no major loss in performance. Conclusion: King Vision™ videolaryngoscope showed comparable or superior clinical performance to the Macintosh, especially regarding first-attempt success and glottic visualization. Despite slightly longer intubation times, it remains a viable and cost-effective alternative in low-resource settings. Further research is needed to strengthen these findings in broader contexts.