Randomized trial of success of pediatric anesthesiologists learning to use two video laryngoscopes

Abstract

The primary purpose of this study was to establish the ability of pediatric anesthesiologists to learn to use two video laryngoscopes - the GlideScope(®) system (GS) and the Karl Storz Direct Coupled Interface, DCI(®), (KS). The number of intubation attempts required to attain proficiency with a video laryngoscope is not known. Baseline intubation times, using direct laryngoscopy, were determined for each anesthesiologist on 20 children. Anesthesiologists were then randomized to perform 20 intubations with the GS or KS before crossing over to the other device. There were 193 successful intubations and eight failed intubations (4.0%) with the GS. Median time-to-intubation with the GS for each anesthesiologist ranged from 24.5 to 32.8 s. There were 193 successful intubations and three failed intubations (1.5%) with the KS (P > 0.05 vs failed attempts with GS). Median time-to-intubation with the KS ranged from 21.9 to 31.1 s. For both the GS and KS, five of eight anesthesiologists met the study definition of 'Success'. There was no correlation between median time-to-intubation with all laryngoscopes combined and years since completion of training. The distribution of Cormack and Lehane scores was almost identical for the GS and KS; there were fewer grade III or IV scores than with direct laryngoscopy (P = 0.03; Fischer's exact test). Mean and median times on intubation no. 16-20 were shorter for the KS than for the GS. Although only 65% of anesthesiologists attained the stringent study definition of 'Success', all rapidly leaned to use both video laryngoscopes.