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Online ISSN 1827-1596
Mohamed R. EL TAHAN, Abdulmohsen A. AL-GHAMDI, Alaa M. KHIDR, Ihab S. GAAROUR
Anesthesiology Department, King Fahd Hospital of the University of Dammam, Dammam, Saudi Arabia
BACKGROUND: The King VisionTM (KVL) and Airtraq® may reduce the time to double lumen tube (DLT) intubation compared with the GlideScope® and Macintosh in simulated easy and difficult airways.
METHODS: Twenty-one consented staff anaesthesiologists who had limited prior experience in using videolaryngoscopes for DLT intubation were assigned randomly to insert a DLT using the Macintosh, GlideScope®, Airtraq® and KVL on easy and difficult airway simulators in a randomized crossover order. Time to DLT intubation, laryngoscopic view, intubation difficulty, optimising manoeuvers and failure to intubation; defined as an attempt took longer than 150s, were recorded.
RESULTS: The 3 videolaryngoscopes had comparable times to intubation and glottis visualisation in both scenarios. Compared with the Macintosh, the KVL had longer intubation times in the simulated easy airway scenario (mean 9.2s vs.21.1s, respectively, P<0.001). In both scenarios, the Airtraq® took a longer intubation time than the Macintosh (P<0.001 and P=0.019, respectively). The GlideScope® was easier to use than the Airtraq® and KVL in the easy airway scenario (P=0.021 and P=0.001, respectively). The KVL had higher intubation difficulty scores than the GlideScope® and Airtraq® (P=0.002 and P=0.008, respectively) in both scenarios and required more frequent optimising manoeuvers than the GlideScope® (P=0.012) in the simulated easy airway. Two participants failed to intubate the difficult airway simulator; one with the Macintosh and the other with the KVL.
CONCLUSIONS: The Airtraq® and non-channelled KVL required more time over the Macintosh for DLT intubation, as a primary outcome, but the success rates for the 3 videolaryngoscopes were very high.