A COMPARATIVE STUDY OF VIDEO LARYNGOSCOPE VERSUS DIRECT LARYNGOSCOPE IN PATIENTS WITH ANTICIPATED DIFFICULT AIRWAY: A PROSPECTIVE OBSERVATIONAL STUDY
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Keywords
Video laryngoscope; Direct laryngoscope; Difficult airway; Intubation; Cormack-Lehane grade; Airway management
Abstract
Background: Airway management remains a critical aspect of anesthetic practice, particularly in patients with anticipated difficult airway. Direct laryngoscopy has been the conventional method for endotracheal intubation; however, video laryngoscopes have emerged as an advanced alternative offering improved visualization.
Objectives: To compare video laryngoscope and direct laryngoscope in patients with anticipated difficult airway with respect to glottic visualization, intubation success rate, number of attempts, time taken for intubation, and associated complications.
Methods: This prospective observational study was conducted in a tertiary care hospital over a period of one year (February 2016 to January 2017). A total of 90 patients with anticipated difficult airway undergoing elective surgery under general anesthesia were included, with 45 patients in each group. Patients were intubated using either video laryngoscope or direct laryngoscope. Parameters assessed included Cormack-Lehane grade, first-attempt success rate, number of attempts, time to intubation, use of adjuncts, and complications. Statistical analysis was performed using SPSS version 20.0, with p<0.05 considered significant.
Results: Baseline characteristics were comparable between the two groups. Video laryngoscopy provided significantly better glottic visualization (84.4% Grade I–II vs 57.8%, p=0.006) and higher first-attempt success rate (86.7% vs 66.7%, p=0.028). The mean number of attempts and requirement of adjuncts were significantly lower in the video laryngoscope group. However, time taken for intubation was significantly longer with video laryngoscopy (28.6 ± 6.4 vs 24.9 ± 5.8 seconds, p=0.004). Complications were lower in the video laryngoscope group but did not reach statistical significance.
Conclusion: Video laryngoscopy is superior to direct laryngoscopy in anticipated difficult airway due to improved visualization and higher success rates, despite a slightly longer intubation time. Its use can enhance airway management and patient safety.
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Dr. Ankur Mehra
Assistant Professor, Department of Anaesthesiology, IQ City Medical College & Hospital, Durgapur, West Bengal, India. (
Dr. Gautam Bhardwaj
Assistant Professor, Department of Anaesthesiology, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India. (
Dr. Rajesh Garg
Assistant Professor, Department of Anaesthesiology, IQ City Medical College & Hospital, Durgapur, West Bengal, India. (
