A Prospective Randomized Comparative Study on Video Laryngoscopy and Direct Laryngoscopy during Endotracheal Intubation

Background: Endotracheal intubation is one of the most common procedures done to secure the airway in patients requiring general anesthesia for surgery for which the traditional method of direct laryngoscope or modern video laryngoscopes are used. In this comparative study, we check the efficacy of video laryngoscope in improving the success rate of intubation over direct laryngoscope. Objectives: Primarily we aim to compare the glottic visualization and time for intubation using both video laryngoscope and direct laryngoscope. As a secondary outcome, we observe the degree of alterations in hemodynamic responses to intubation using both video laryngoscopes and direct laryngoscopes. Materials and Methods: A randomized prospective observational study conducted at a private hospital, Chennai within period of 2 months. The study population was 102 patients of either sex aged 20-85 years of which 51 were recruited for intubation using video laryngoscope(Group A) and remaining 51 with direct laryngoscope(Group B). Statistical analysis was done using independent samples t-test and Chi-square test. Results: Mean time for glottic view was 25.00 seconds in group A compared to 36.75 seconds in group B. Mean time for intubation in group A was 50.14 seconds and in group B it was 69.92 seconds. We observed full laryngeal view significantly more in group A (84.3%) than in group B (64.7%). Ease of intubation was found to be easier in group A (68.6%) than in group B (54.9%). Regarding hemodynamic responses, there was statistically significant difference between two groups after intubation for the mean heart rate and for mean systolic blood pressure. Conclusion: In this study, we observed significant reduction in time for intubation and improved glottic visualization using video laryngoscope, thus improving success rate of intubation compared to direct laryngoscope.