Conventional Direct Laryngoscopy Research Articles

A comparison of the McGrath videolaryngoscope with direct laryngoscopy for rapid sequence intubation in the operating theatre: a multicentre randomised controlled trial.

Aspiration of gastric contents is a recognised complication during all phases of anaesthesia. The risk of this event becomes more likely with repeated attempts at tracheal intubation. There is a lack of clinical data on the effectiveness of videolaryngoscopy relative to direct laryngoscopy rapid sequence intubation in the operating theatre. We hypothesised that the use of a videolaryngoscope during rapid sequence intubation would be associated with a higher first pass tracheal intubation success rate than conventional direct laryngoscopy. In this multicentre randomised controlled trial, 1000 adult patients requiring tracheal intubation for elective, urgent or emergency surgery were allocated randomly to airway management using a McGrath™ MAC videolaryngoscope (Medtronic, Minneapolis, MN, USA) or direct laryngoscopy. Both techniques used a Macintosh blade. First-pass tracheal intubation success was higher in patients allocated to the McGrath group (470/500, 94%) compared with those allocated to the direct laryngoscopy group (358/500, 71.6%), odds ratio (95%CI) 1.31 (1.23-1.39); p < 0.001. This advantage was observed in both trainees and consultants. Cormack and Lehane grade ≥ 3 view occurred less frequently in patients allocated to the McGrath group compared with those allocated to the direct laryngoscopy group (5/500, 1% vs. 94/500, 19%, respectively; p < 0.001). Tracheal intubation with a McGrath videolaryngoscope was associated with a lower rate of adverse events compared with direct laryngoscopy (13/500, 2.6% vs. 61/500, 12.2%, respectively; p < 0.001). These findings suggest that the McGrath videolaryngoscope is superior to a conventional direct laryngoscope for rapid sequence intubation in the operating theatre.

How does videolaryngoscopy compare with conventional direct laryngoscopy for neonatal tracheal intubation?

How does videolaryngoscopy compare with conventional direct laryngoscopy for neonatal tracheal intubation?

Evaluation of free-floating tracheal intubation in weightlessness via ice-pick position with a direct laryngoscopy and classic approach with indirect videolaryngoscopy

Long duration spaceflights to the Moon or Mars are at risk for emergency medical events. Managing a hypoxemic distress and performing an advanced airway procedure such as oro-tracheal intubation may be complicated under weightlessness due to ergonomic constraints. An emergency free-floating intubation would be dangerous because of high failure rates due to stabilization issues that prohibits its implementation in a space environment. Nevertheless, we hypothesized that two configurations could lead to a high first-pass success score for intubation performed by a free-floating operator. In a non-randomized, controlled, cross-over simulation study during a parabolic flight campaign, we evaluated and compared the intubation performance of free-floating trained operators, using either a conventional direct laryngoscope in an ice-pick position or an indirect laryngoscopy with a video-laryngoscope in a classic position at the head of a high-fidelity simulation manikin, in weightlessness and in normogravity. Neither of the two tested conditions reached the minimal terrestrial ILCOR recommendations (95% first-pass success) and therefore could not be recommended for general implementation under weightlessness conditions. Free-floating video laryngoscopy at the head of the manikin had a significant better success score than conventional direct laryngoscopy in an ice-pick position. Our results, combined with the preexisting literature, emphasis the difficulties of performing oro-tracheal intubation, even for experts using modern airway devices, under postural instability in weightlessness. ClinicalTrials registration number NCT05303948.

Non-channeled Video Laryngoscopy as an Alternative to Conventional Laryngoscopy for Intubating Adult Patients in the Intensive Care Unit.

Background Endotracheal intubation in the intensive care unit (ICU) is often a risky procedure due to the emergency situation, unstable condition of the patient, and technical problems such as inadequate positioning. Several new techniques, such as video laryngoscopy, have been developed recently to improve the success rate of first-pass intubations and reduce complications. We conducted this study to compare a non-channeled reusable video laryngoscope BPL VL-02 (manufactured by BPL Medical Technologies, Bangalore, India) with a conventional laryngoscope for intubation of adult patients in the ICU. Methodology A total of 72 ICU patients were randomly allocated to be intubated with either conventional direct laryngoscopy via Macintosh blade (group A) or video laryngoscopy with BPL VL-02 (group B). All patients were intubated by the primary investigator and the assistant noted the following parameters: the total number of intubation attempts, total duration of intubation, assistance or alternative technique required, Cormack Lehane grading, and any complications. Results There was no significant difference in the Cormack Lehane grading, number of attempts, or complications between the two groups. On comparing the assistance required during intubation in patients, it was observed that four (11.11%) patients in group A and seven (19.44%) patients in group B needed backward, upward, and rightward pressure on the larynx assistance during intubation. In five (13.89%) patients in group B, Stylet was required during intubation. The difference was statisticallysignificant (p = 0.0308). The video laryngoscopy group (group B) had a longer mean duration of intubation (64.36 ± 6.28 seconds) compared to group A (45.72 ± 11.45 seconds), and the difference was statistically significant (p < 0.0001). Conclusions Non-channeled video laryngoscope (BPL VL-02) is not a suitable alternative to conventional direct laryngoscopy with a Macintosh blade in terms of successful first-pass intubation, total duration of intubation, and assistance required.

A prospective cohort evaluation of the McGrath™ MAC videolaryngoscope in a series of 979 cases

BackgroundEvidence favouring the effectiveness of videolaryngoscopes over conventional direct laryngoscopy for facilitating successful tracheal intubation has been growing. However, to choose between different devices, clinicians need to know how individual devices perform outside of carefully controlled clinical trials. AimTo evaluate the effectiveness of the McGrath MAC videolaryngoscope as it was introduced into clinical practice. MethodsCohort evaluation of McGrath MAC videolaryngoscope use in clinical practice by voluntary completion of an evaluation form over a two-year period. ResultsIn a total of 979 cases, tracheal intubation was successful in 955/979 (97.5%), with first pass success achieved in 785/955 (82.2%). Most tracheal intubations (964/979, 80.1%) were performed during ‘office hours’ (Monday to Friday 0800-1800). Senior anaesthetists conducted 423/970 (43.6%) of intubations. There were 24/979 (2.5%) failed intubations, with consultants or senior anaesthetists conducting laryngoscopy in the majority of these; in 16/22 failed intubations, a grade I or II glottic view was obtained on the videolaryngoscope screen. Of the 20 anaesthetists involved as intubators, 14 had used the device fewer than 50 times. ConclusionOur historical results demonstrate the effectiveness and feasibility of using the McGrath MAC videolaryngoscope to facilitate tracheal intubation in clinical practice. However, we believe the most important finding was the number of “easy” grade I and II glottic views on videolaryngoscopy where tracheal intubation was not achieved. Our experience and the evidence suggest that in order to fully realise the numerous benefits of videolaryngoscopy, the introduction of formal teaching and instruction by trained trainers is essential.

Iatrogenic Tension Pneumothorax after Fiberoptic-guided Intubation in a Pediatric Patient: A Case Report

Fiberoptic-guided intubation (FOI) has been an indispensable component of difficult airway management especially in instances where anatomical limitations precluded use of conventional direct laryngoscopy. Its use, however, is not without risks.This paper presents a 4-year-old female with a limited mouth opening scheduled for an elective oral commissurotomy who developed signs and symptoms of tension pneumothorax immediately following a successful fiberoptic nasotracheal intubation. Passive insufflation of high-flow oxygen through a flexible fiberoptic bronchoscope preloaded with a tight-fitting endotracheal tube led to accumulation of air. This caused lung hyperinflation and subsequently, pneumothorax.

Video Laryngoscopy Using King Vision™ aBlade™ and Direct Laryngoscopy in Paediatric Airway Management: A Randomized Controlled Study about Device Learning by Anaesthesia Residents.

Background: Airway management in children is challenging due to anatomical and physiological differences. This randomized trial investigates whether anaesthesia residents can intubate the paediatric trachea more quickly and with a higher success rate using the King Vision™ Paediatric aBlade™ video laryngoscope (KVL) compared to conventional direct laryngoscopy (DL). Methods: Eleven anaesthesia residents (mean age: 31 years, mean training status 47 months) were each asked to perform intubations with the KVL and DL in paediatric patients. The primary outcome was the first-attempt success rate. Secondary outcomes were the time to best view (TTBV), time to placement of the tracheal tube (TTP), time to ventilation (TTV), and participant-reported ease of use on a Likert scale. Results: 105 intubations with the KVL and 106 DL were performed by the residents. The success rate on the first attempt with the KVL was 81%, and the success rate on the first attempt within a given time limit of 30 s was 45%, which was lower than with DL (93% and 77% with time limit, p < 0.01). The median TTBV [IQR] on the first attempt with KVL was 7 [5–10] s, the median TTP was 28 [19–44] s, and the median TTV was 51 [39–66] s. DL-mediated intubation was significantly faster (TTP: 17 [13–23] s; p < 0.0001 and TTV: 34 [28–44] s; p < 0.001). Application of the KVL was rated as difficult or very difficult by 60% of the residents (DL: 5%). Conclusion: In contrast to promising data on the paediatric training manikin, residents took longer to intubate the airway in children with the KVL and were less successful compared to the DL. Therefore, the KVL should not be recommended for learning paediatric intubation by residents.

The Role of Modified Killian's Method in the Evaluation of Hypopharyngeal and Supraglottic Cancers.

Priyanka Schilling AmarObjectives Hypopharyngeal cancer is one of the upper aerodigestive tract malignancies with the poorest prognosis. The aim of this study was to assess the role of modified Killian's (MK) method in routine, outpatient-based flexible laryngoscopy to improve visualization and assess the extent of supraglottic and hypopharyngeal cancers. Materials and Methods An observational study was conducted in a tertiary hospital in India where fifty consecutive patients who presented to the outpatient clinic with suspected hypopharyngeal and supraglottic malignancy underwent a conventional laryngoscopy as well as MK method. The site and extent of the tumor on endoscopy were recorded and the videos were graded independently by two investigators on Murono's scale from 1 to 5. A subset of these patients who underwent direct laryngoscopy under general anesthesia was also scored with the above scale. The scores were compared to check the accuracy of flexible laryngoscopy with the MK method in staging cancer. Statistical Analysis Descriptive statistics were given using mean (standard deviation [SD]) for continuous variables and frequency (percentage) for categorical variables. The difference between the mean scores was analyzed using the paired-t test. The agreement between the scales and the observer, that is, the inter- and intraobserver agreement, was presented with concordance rate and Kappa weighted analysis. Results In this study, the mean scores of the Murono's scale grading of the conventional method, MK method, and direct laryngoscopy were 1.42 (SD: 0.64), 2.94 (SD: 0.95), and 4.30 (SD: 1.49), respectively, which showed significant improvement in scores with MK method. In addition, the subset analysis demonstrated a significant agreement between direct laryngoscopy and MK method. Conclusion The MK method is a good diagnostic test and a valuable adjunct to diagnostic flexible laryngoscopy in the evaluation and staging of hypopharyngeal and supraglottic cancers.

Comparison of Haemodynamic Response to Endotracheal Intubation with Videolaryngoscopy and Direct Laryngoscopy in Hypertensive Patients- A Randomised Clinical Trial

Introduction: Cardiovascular responses to direct laryngoscopy and endotracheal intubation have been well documented and are caused by noxious stimuli. A videolaryngoscope facilitates visualisation of the vocal cords with minimal stretch on the airways. Aim: To compare the haemodynamic responses to endotracheal intubation with videolaryngoscopy and direct laryngoscopy in hypertensive patients. Materials and Methods: A randomised clinical trial conducted in 90 hypertensive patients. The patients were divided into two groups- Group D in whom conventional (Macintosh) direct laryngoscopy was used and Group V in whom (C-MAC) videolaryngoscopy was used. Haemodynamic parameters were monitored postintubation and to also study the number of intubation attempts, total time taken for intubation, assessment of Cormack-Lehane grade (C-L grade) between C-MAC videolaryngoscopy and direct laryngoscopy. Between the group analyses done using student’s t-test. Multiple paired t-test was used for within group data analysis. Chi-square was used to compare categorical data between the two groups. The p&lt;0.05 will be considered statistically significant. Results: There was no significant difference in haemodynamic response to intubation between both videolaryngoscopy and direct laryngoscopy groups after intubation (p&gt;0.05). Glottic visualisation was significantly better in videolaryngoscopy group using C-L grade (p-value=0.0313). There was no significant difference between the two groups with respect total time taken for laryngoscopy (p-value=0.072). Conclusion: Videolaryngocopy does not have any added advantage over direct laryngoscopy as per Haemodynamic response is considered. Though the visualisation of the glottis is better with videolaryngoscope, duration of laryngoscopy does not differ from routine laryngoscopy

Extreme bradycardia during microsurgery of the larynx

Introduction: Successful anesthetic management of microlaryngeal cases requires a high degree of cooperation with the surgeon, a reciprocal understanding of the potential problems, and adequate preparation on both sides to meet the anticipated challenges that may arise. Case description: A 55-year-old male patient (weight 104 kg, height 176 cm), ASA III, was admitted to our hospital for microlaryngeal surgery because of tumor formation of the larynx. The preoperative evaluation revealed no significant personal or family history for adverse reaction to anesthetics. A general anesthesia was scheduled for this patient. Fentanyl 0.3 mg, atropine 0.5 mg, propofol 220 mg and succinylcholine 130 mg were administered for anesthesia induction. After intubation 2.5% sevoflurane was used for anesthesia maintenance. After endotracheal intubation was performed surgeon tried to put on the tube of Kleinsasser. During this procedure the heart rate of the patient extremely dropped from 85 to 25 beats per minute. Discussion: Performance of conventional and operative direct laryngoscopy, supraglottic tissue distention, and laryngeal stimulation elicit intense cardiovascular responses, resulting in tachycardia, arterial and pulmonary hypertension, and arrhythmias. Although these responses are usually short lived, myocardial ischemia and compromise of cerebral circulation may occur in high-risk patients, resulting in adverse outcomes. Conclusion: There is a risk of severe bradycardia after putting on the tube of Kleinsasser during microlaryngeal surgery, which can cause hemodynamic

Effectiveness of standard direct laryngoscopy with a Macintosh blade, the McGrath videolaryngoscope, and the Airtraq optical laryngoscopes for assessment of vocal cord mobility following thyroid surgery

BackgroundAccurate and timely evaluation of vocal cord function following thyroid surgery relieves the stress of both surgeon and anesthesiologist along with optimizing ongoing management. Conventional direct laryngoscopy is the commonly used tool for vocal cord assessment during extubation in thyroid surgeries. Videolaryngoscopes, are not well researched as an equipment to prognosticate extubation in thyroid surgery. Appropriate visualization and assessment of vocal cords during extubation with videolaryngoscopes can be useful for record keeping and documentation. This study was therefore conducted to compare the conventional direct laryngoscopy with prototypes of channeled and non-channeled videolaryngoscopes – Airtraq and McGrath respectively for extubation in thyroid surgery. ObjectiveThe aim of the study was to compare laryngoscopic view, vocal cord mobility during extubation after thyroid surgeries and to assess patient comfort during laryngoscopy. MethodsFollowing approval from the Institutional Ethics board and informed consent from the patients, a prospective randomised study was conducted in 66 patients. Patients posted for elective thyroid surgery were recruited and followed a routine anaesthesia protocol for intubation. Towards the end of surgery dexmedetomidine infusion was started and patients appropriately reversed. Depending on the group, allotted patients underwent laryngoscopy either with standard direct laryngoscope with the Macintosh blade, McGrath MAC blade 3, or Airtraq size 3 optical laryngoscope. During laryngoscopy Cormack-Lehane grading, vocal cord mobility and patient reactivity were assessed and patients were extubated. ResultsGlottic visualization as assessed by the Cormack-Lehane grades were comparable among the three groups. Change in the Cormack-Lehane grading when compared with the one at the time of intubation was better with Airtraq than the other two groups with a p value of 0.023. The patient reactivity score was statistically significant between the groups (p = 0.006), and Airtraq scored better. The Ramsay sedation scores at different time intervals was not significant between the groups. Vocal cord mobility grading and complications were not different between the three groups. ConclusionVideolaryngoscopes provide a better glottic view during extubation with better patient reactivity scores. Airtraq outperformed standard laryngoscope and McGrath having better Cormack-Lehane grades and a better patient reactivity score.

Comparative efficacy of C-MAC® Miller videolaryngoscope versus McGrath® MAC size "1" videolaryngoscope in neonates and infants undergoing surgical procedures under general anesthesia: A prospective randomized controlled trial.

Various anatomical and physiological factors make intubation in infants challenging. C-MAC videolaryngoscope shows better results as compared to the conventional direct laryngoscopy for intubation in infants. McGrath MAC size-1 with a disposable Macintosh type blade has recently been introduced for use in infants and has not been formally evaluated in this population. This study aims to evaluate the intubation characteristics of C-MAC Miller and McGrath MAC in neonates and infants with the primary objective to compare the time with the two devices. After informed consent from the parents, 140 neonates and infants scheduled for surgical procedures were randomized to undergo intubation with either C-MAC Miller or McGrath MAC after standard general anesthesia. The two devices were compared in terms of total intubation time, Percent of Glottic Opening score, Cormack Lehane grades, time to glottis view, intubation difficulty score, overall success rate, first attempt success rate, and complications. The median glottic view time (6s [4-9] vs. 6s [4-9]; p=.40) and intubation time (27s [25.5-28] vs. 27s [24.5-29.5]; p=.87) were similar. The mean difference (95% CI) in time to tracheal intubation and time to glottic view was 0.49s [-3.1 to 2.1] and -1.7s [-3.8 to 0.47], respectively. However, the Percent of Glottic Opening score, Cormack Lehane grades, and subjective intubation difficulty were significantly better with C-MAC. The first attempt success rates, overall success rates (100% vs. 97.5%), and intubation difficulty scores were comparable. There were two failed intubations with McGrath which were successfully intubated with C-MAC. The C-MAC Miller blade showed similar intubation timings, success rates, and intubation difficulty score as compared to McGrath MAC in neonates and infants, though the former provided superior glottic views. Both the videolaryngoscopes may be safely used in infants and neonates for routine intubation scenarios.

Tracheal Intubation Using a Videolaryngoscope Assisted by Transtracheal Illumination with an LED Vein Finder

Introduction: Retrograde illumination of the glottis using an LED vein finder placed over the cricothyroid membrane produces a red-orange glow of light inside the airway that can be used to assist the intubator during videolaryngoscopy. The endotracheal tube can be guided through this red-orange glow illuminating the glottis and trachea. Patients and Methods: In this prospective, randomised, single-blinded study, a total of 200 patients posted for elective head and neck cancer surgeries were included. Patients were placed supine with their heads in a neutral position without a pillow. Intubation was done with The Anesthetist Scope videolaryngoscope in Group TI (transillumination) with an assistant holding the LED vein finder over the cricothyroid membrane. The glottic opening was identified by a red-orange glow within the airway and the intubation was performed. In Group C (conventional direct laryngoscopy), transillumination was not done during intubation. Exposure time was taken from the time when the patient's mouth was opened to the time when the best glottic view was obtained. Intubation time was noted from the introduction of the videolaryngoscope or conventional laryngoscope into the mouth, through successful intubation and identification of 3 complete capnographic waveforms. A total of three attempts were allowed for each patient. Results: The success rate was better in Group TI. Exposure time and intubation time were shorter in Group TI as compared to Group C. In three patients with carcinoma of the vocal cords, the glottic opening was identified only by retrograde light transmission from the vein finder. Conclusion: A combination of videolaryngoscopy and LED vein finder is an effective method to achieve a better success rate of tracheal intubation.

Videolaryngoscopy versus direct laryngoscopy for double-lumen endotracheal tube intubation in thoracic surgery - a randomised controlled clinical trial

BackgroundDouble-lumen tube (DLT) intubation is necessary for thoracic surgery and other operations with the need for lung separation. However, DLT insertion is complex and might result in airway trauma. A new videolaryngoscopy (GVL) with a thin blade might improve the intubation time and reduce complexity as well as iatrogenic airway complications compared to conventional direct laryngoscopy (DL) for DLT intubation.MethodsA randomised, controlled trial was conducted in 70 patients undergoing elective thoracic surgery using DLT for lung separation. Primary endpoint was time to successful intubation. The secondary endpoints of this study were number of intubation attempts, the assessment of difficulty, any complications during DLT intubation and the incidence of objective trauma of the oropharynx and supraglottic space and intubation-related subjective symptoms.Results65 patients were included (DL group [n = 31], GVL group [n = 34]). Median intubation time (25th–75th percentiles) in GVL group was 93 s (63–160) versus 74 (58–94) in DL group [p = 0.044]. GVL resulted in significantly improved visualisation of the larynx (Cormack and Lehane grade of 1 in GVL group was 97% vs. 74% in DL Group [p = 0.008]). Endoscopic examinations revealed significant differences in GVL group compared to DL group showing less red-blooded vocal cord [p = 0.004], vocal cord haematoma [p = 0.022] and vocal cord haemorrhage [p = 0.002]. No significant differences regarding the postoperative subjective symptoms of airway were found.ConclusionsVideolaryngoscopy using the GlideScope®-Titanium shortly prolongs DLT intubation duration compared to direct laryngoscopy but improves the view. Objective intubation trauma but not subjective complaints are reduced.Trial registrationGerman Clinical Trial Register DRKS00020978, retrospectively registered on 09. March 2020.

Ultrasound is a reliable and faster tool for confirmation of endotracheal intubation compared to chest auscultation and capnography when performed by novice anaesthesia residents - A prospective controlled clinical trial.

Background:Anesthesia trainee may initially take longer time to intubate and unintentionally place the endotracheal tube (ETT) in the esophagus. The present study determined if ultrasound is the fastest method of confirmation of correct placement of ETT compared to capnography, and chest auscultation in trainees.Methods:First year anesthesia residents performed intubation in 120 patients recruited after ethical clearance and informed consent. Time to visualize flutter in trachea, double trachea sign, time to appearance of first and sixth capnography, and time to execute chest auscultation was noted.Results:Ultrasonography was statistically fastest method to determine endotracheal intubation (36.50 ± 15.14 seconds) vs unilateral chest auscultation (50.29 ± 15.50 seconds) vs bilateral chest auscultation (51.90 ± 15.98 seconds) vs capnography first waveform (53.57 ± 15.97 seconds) vs capnography sixth waveform (61.67 ± 15.88 seconds).Conclusion:When teaching endotracheal intubation to novice anesthesia residents using conventional direct laryngoscopy, ultrasonography is the fastest method to confirm correct ETT placement compared to capnograph and chest auscultation. Mentor can guide trainee to direct ETT towards trachea and can promptly detect esophageal intubation by double trachea sign.

Recent advances in laryngoscopy in adults.

Recent advances in technology have made laryngoscopy less dependent upon a direct line of sight to achieve tracheal intubation. Whether these new devices are useful tools capable of increasing patient safety depends upon when and how they are used. We briefly consider the challenges in reviewing the emerging literature given the variety of devices, “experience” of the care providers, the clinical settings, and the definitions of outcome. We examine some of the limitations of conventional direct laryngoscopy, question the definitions we have used to define success, discuss the benefits of indirect (video) techniques, and review evidence pertaining to their use in the patients in the operating room, emergency department, and intensive care unit.

C-MAC Video Laryngoscope versus Conventional Direct Laryngoscopy for Endotracheal Intubation During Cardiopulmonary Resuscitation.

Background and objectives: To compare the first pass success (FPS) rate of the C-MAC video laryngoscope (C-MAC) and conventional Macintosh-type direct laryngoscopy (DL) during cardiopulmonary resuscitation (CPR) in the emergency department (ED). Materials and Methods: This study was a single-center, retrospective study conducted from April 2014 to July 2018. Patients were categorized into either the C-MAC or DL group, according to the device used on the first endotracheal intubation (ETI) attempt. The primary outcome was the FPS rate. A multiple logistic regression model was developed to identify factors related to the FPS. Results: A total of 573 ETIs were performed. Of the eligible cases, 263 and 310 patients were assigned to the C-MAC and DL group, respectively. The overall FPS rate was 75% (n = 431/573). The FPS rate was higher in the C-MAC group than in the DL group, but there was no statistically significant difference (total n = 431, 79% compared to 72%, p = 0.075). In the multiple logistic regression analysis, the C-MAC use had higher FPS rate (adjusted odds ratio: 1.80; 95% CI, 1.17–2.77; p = 0.007) than that of the DL use. Conclusions: The C-MAC use on the first ETI attempt during cardiopulmonary resuscitation in the emergency department had a higher FPS rate than that of the DL use.

Challenging the Traditional Definition of a Difficult Intubation: What Is Difficult?

Challenging the Traditional Definition of a Difficult Intubation: What Is Difficult?

Early clinical experience with The Anesthetist Society (TAS) scope (an indigenous videolaryngoscope).

Tracheal intubation is the preferred technique for mechanical ventilation. However, standard tracheal intubation via conventional direct laryngoscopy (DLS), performed by untrained medical personnel has high incidence of failure. Success rate by medical support staff, medical students and novice anaesthesia residents is stated to be between 35% and 65%.[1] Alternative approaches for improving the success rates include use of videolaryngoscopy (VLS), which provides better view of the glottis and higher success rate.[2] It does not depend on alignment of the optical axes in the pharynx and mouth.[3] It is more effective but can be time-consuming but the steepness of the learning curve may be less than that with DLS for a novice.[4] The main hurdle in DLS with Macintosh laryngoscope is the visual restriction inherent to the procedure caused by a need to get straight line of sight to visualise the glottis, blade flange, tongue and epiglottis making the procedure monocular at the level of the larynx.[5] Video laryngoscopes (VLS) represent a breakthrough in airway management. They are available in various designs and blade shapes, with specific applications in selected case groups. Most of the VLS available in market are cumbersome to use and expensive. The need of the hour is a user-friendly and economical VLS. TAScope (The Anaesthetist Society scope) is an indigenously designed VLS by a fraternity member. It is a channelled, anatomically angulated video intubation aid with an endoscopic camera which can be connected to mobile phones and tablets.[6] After satisfactory manikin trial in the institute, this preliminary human study was done to evaluate TAScope in comparison to Macintosh laryngoscope.

Conventional Direct Laryngoscopy needs wind up with the advent of Video laryngoscopes– Comparative Study

Conventional Direct Laryngoscopy needs wind up with the advent of Video laryngoscopes– Comparative Study