Comparison of channelled with non-channelled blade of King Vision videolaryngoscope for orotracheal intubation in patients undergoing emergency surgery: A randomised double blind study

Abstract

BackgroundPatients undergoing emergency surgery can have both anatomical and physiological difficult airways. There being no consensus on the best strategy to secure such airways, hence the present study evaluated the clinical performance of the two blades of King Vision™ Videolaryngoscope (KVVL). MethodsThis prospective double blind study was done on fifty two patients of 18–80 years aged posted for emergency surgery under general anaesthesia (GA). Patients were randomly assigned to channelled (CH) and non-channelled (NC) group for intubation. The primary outcome was time to tracheal intubation with CH and NC blades. The secondary outcomes among the two groups noted were ease of videolaryngoscope (VL) blade insertion, time to optimal laryngeal view, fremantle score, number of intubation attempts, any manoeuver required to intubate and complications. Haemodynamic parameters were noted before induction, during preoxygenation before laryngoscopy and 5 min after endotracheal intubation. ResultsSignificant shorter time to intubation was noted in NC group (18s) compared with CH group (25s). The NC blade was easier to insert and the time to optimal laryngeal view was also shorter with NC group (7s) as compared to CH group (10s). Fremantle score was comparable among the two groups. Endotracheal tube (ETT) impingment on arytenoids was more common with NC blade. For intubation with CH blade, anticlockwise rotation of ETT was frequently required. ConclusionThe NC blade of KVVL was easier to introduce and resulted in faster intubation, thus favouring its use in patients undergoing emergency surgery under GA. The CH blade of KVVL required anticlockwise rotation to facilitate intubation.