Hyper-angulated (Glidescope) versus intermediate-angled (UED-A) videolaryngoscopy for routine tracheal intubation in adults: a prospective randomized controlled trial

Videolaryngoscopy (VL) has become the gold standard for airway management. However, performance differences among blade geometries-especially between hyper-angulated and intermediate-angled designs-remain underexplored in routine airway management. We conducted a prospective randomized controlled trial comparing a hyper-angulated videolaryngoscope (GlideScope) and a novel intermediate-angled device (UED-A) during elective tracheal intubation of sixty adult patients. Patients were randomized to either device, with total intubation time as the primary outcome. Secondary outcomes included first-pass success, time to glottic visualization, number of attempts, external manipulation, Cormack-Lehane grade, adverse events, and user satisfaction. All patients were successfully intubated. No statistically significant differences were observed between groups in total intubation time (UED-A: 30.9 ± 13.8 s vs. GlideScope: 29.5 ± 13.0 s; p = 0.73), time to glottic visualization (UED-A: 12.9 ± 4.7 s vs. GlideScope: 13.5 ± 5.4 s; p = 0.74), or first-pass success (UED-A: 93% vs. GlideScope: 97%; p > 0.99). Other secondary outcomes were also comparable between devices. In routine adult tracheal intubation, the intermediate-angled UED-A videolaryngoscope demonstrated a non-inferior performance to GlideScope, indicating that both devices offer similarly effective and user-friendly options for standard airway management. This suggests that intermediate-angled UED-A videolaryngoscope may serve as viable alternatives to hyper-angulated GlideScope in clinical practice. Registry: ClinicalTrials.gov, TRN: NCT05721690, Registration date: February 1, 2023.