Tracheal intubation with King Vision video laryngoscope in patients with cervical spine instability-Comparison of straight versus curved reinforced endotracheal tubes.

Abstract

Background and Aims:King Vision video laryngoscope is commonly used to facilitate intubation in corrective surgery for cervical spine instability patients due to less manipulation. Curved and straight reinforced tracheal tubes are regularly used in this surgery as neck of the patient is likely to be flexed. We aimed to compare intubation characteristics between the curved and straight reinforced tubes through King Vision video laryngoscope in patients to be operated for cervical spine instability with the primary objective being intubation time.Methods:Sixty patients undergoing cervical spine surgery were enroled in this prospective randomised comparative clinical study. All were intubated after applying manual in-line stabilisation of the neck, using either curved (group C) or straight (group S) reinforced endotracheal tubes through King Vision video laryngoscope. The intubation time, number of attempts, incidence of tube impingement with arytenoids/aryepiglottic folds, optimisation manoeuvres required and complications were observed. Unpaired ‘t’ test and Chi-square test were used to analyse the data using MedCalc software, version 12.5.Results:Time taken for intubation was shorter with curved compared to straight reinforced tube (16.24 ± 3.09 vs. 29.08 ± 5.48 seconds, P < 0.0001) The first attempt success rate was higher using curved than straight reinforced tube (93.3% vs. 70%, P = 0.02). Incidences of impingement with arytenoids/ aryepiglottic folds and optimisation manoeuvres required more with the straight reinforced tube.Conclusion:The intubation was fast and with higher first attempt success rate with curved than with straight reinforced tube through King Vision videolaryngoscope when used in patients with cervical spine instability.