Prospective Comparison of Intubating Condition with King Vision Video Laryngoscope and Macintosh Laryngoscope in Randomly Selected Elective Adult Surgical Patients

Download Article

DOI: 10.21522/TIJPH.2013.12.04.Art027

Authors : Kala Balasubramanian, Bhagyavardhan Botta, Yogarajan Ramalingam, Hariharan Lyla Manojji, Purshothaman R, Bageerathi B R, Selvamani S

Abstract:

Intubation is a crucial medical procedure that involves the insertion of a tube into the airway to ensure proper breathing and save lives. This technique, which is fundamental in the field of anaesthesia, requires skill and precision. Anaesthesiologists play a key role in mastering, teaching, and performing intubations, making it a cornerstone of their practice for many years. Traditionally, machine learning has been utilized as a reliable method for tracheal cannulation, establishing itself as the gold standard over the past seven decades. In recent times, there has been a notable development in intubation technology with the introduction of alternative devices such as the King Vision Video Laryngoscope (KVVL). Unlike the conventional method that relies on direct visualization, the KVVL utilizes an indirect magnified image for enhanced accuracy during the procedure. A comparative study was conducted between the King Vision Video Laryngoscope and the traditional Macintosh Laryngoscope on two groups of patients, with Group A consisting of 70% male and 30% female, and Group B with 60% male and 40% female participants. The results of the study revealed that while BMI, thyromental distance, and MPC showed no significant differences between the two devices, the King Vision Video Laryngoscope outperformed the Macintosh Laryngoscope in terms of intubation difficulty score and Cormack Lehane grading. Moreover, the former demonstrated superior outcomes in terms of airway trauma, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and saturation levels, ensuring a smoother and safer intubation process overall. Based on these findings, the study concluded that the King Vision Video Laryngoscope offers distinct advantages over the traditional Macintosh Laryngoscope, highlighting its potential as a superior tool for efficient and effective airway management in clinical settings.

References:

[1] Mort, T. C. 2004. Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts. Anesthesia & Analgesia, 99(2), 607-613.

[2] Mort, T. C. 2005. Esophageal intubation with indirect clinical tests during emergency tracheal intubation: a report on patient morbidity. Journal of Clinical Anesthesia, 17(4), 255-262.

[3] Tse, J. C., Rimm, E. B., & Hussain, A. 1997. Predicting difficult endotracheal intubation in surgical patients schedules for general anesthesia: a prospective blind study. Journal of Emergency Medicine, 2(15), 266.

[4] Cheney, F. W. 1999. The American Society of Anesthesiologists Closed Claims Project: what have we learned, how has it affected practice, and how will it affect practice in the future?. The Journal of the American Society of Anesthesiologists, 91(2), 552-556.

[5] Peterson, G. N., Domino, K. B., Caplan, R. A., Posner, K. L., Lee, L. A., & Cheney, F. W. 2005. Management of the difficult airway: a closed claims analysis. The Journal of the American Society of Anesthesiologists, 103(1), 33-39.

[6] Cook, T., Woodall, N., Harper, J., Benger, J., & Fourth National Audit Project. 2011. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 2: intensive care and emergency departments. British journal of anaesthesia, 106(5), 632-642.

[7] Woodall, N. M., Benger, J. R., Harper, J. S., & Cook, T. M. 2012. Airway management complications during anaesthesia, in intensive care units and in emergency departments in the UK. Trends in Anaesthesia and Critical Care, 2(2), 58-64.

[8] Metzner, J., Posner, K. L., & Domino, K. B. 2009. The risk and safety of anesthesia at remote locations: the US closed claims analysis. Current Opinion in Anesthesiology, 22(4), 502-508.

[9] Aziz, M. F., Dillman, D., Fu, R., & Brambrink, A. M. 2012. Comparative effectiveness of the C-MAC video laryngoscope versus direct laryngoscopy in the setting of the predicted difficult airway. The Journal of the American Society of Anesthesiologists, 116(3), 629-636.

[10] Gaszynska, E., & Gaszynski, T. 2014. The King Vision™ video laryngoscope for awake intubation: series of cases and literature review. Therapeutics and clinical risk management, 475-478.

[11] Akihisa, Y., Maruyama, K., Koyama, Y., Yamada, R., Ogura, A., & Andoh, T. 2014. Comparison of intubation performance between the King Vision and Macintosh laryngoscopes in novice personnel: a randomized, crossover manikin study. Journal of anesthesia, 28, 51-57.

[12] Murphy, L. D., Kovacs, G. J., Reardon, P. M., & Law, J. A. 2014. Comparison of the king vision video laryngoscope with the macintosh laryngoscope. The Journal of emergency medicine, 47(2), 239-246.

[13] Yun, B. J., Brown, C. A., Grazioso, C. J., Pozner, C. N., & Raja, A. S. 2014. Comparison of video, optical, and direct laryngoscopy by experienced tactical paramedics. Prehospital Emergency Care, 18(3), 442-445.

[14] Asai, T. 2012. Videolaryngoscopes: do they truly have roles in difficult airways?. The Journal of the American Society of Anesthesiologists, 116(3), 515-517.

[15] Miceli, L., Cecconi, M., Tripi, G., Zauli, M., & Della Rocca, G. 2008. Evaluation of new laryngoscope blade for tracheal intubation, Truview EVO2©: a manikin study. European journal of anaesthesiology, 25(6), 446-449.

[16] Ezri, T., Warters, R. D., Szmuk, P., Saad-Eddin, H., Geva, D., Katz, J., & Hagberg, C. 2001. The incidence of class “zero” airway and the impact of Mallampati score, age, sex, and body mass index on prediction of laryngoscopy grade. Anesthesia & Analgesia, 93(4), 1073-1075.

[17] Jarvis, J. L., McClure, S. F., & Johns, D. 2015. EMS intubation improves with King Vision video laryngoscopy. Prehospital Emergency Care, 19(4), 482-489.

[18] Apfelbaum, J. L., Hagberg, C. A., Caplan, R. A., Blitt, C. D., Connis, R. T., ... & Ovassapian, A. 2013. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology, 118(2), 251-270.

[19] Schoettker, P., & Corniche, J. 2015. The AirView Study: Comparison of Intubation Conditions and Ease between the Airtraq‐Air View and the King Vision. BioMed research international, 2015(1), 284142.

[20] Cortellazzi, P., Caldiroli, D., Byrne, A., Sommariva, A., Orena, E. F., & Tramacere, I. 2015. Defining and developing expertise in tracheal intubation using a GlideScope® for anaesthetists with expertise in Macintosh direct laryngoscopy: an in‐vivo longitudinal study. Anaesthesia, 70(3), 290-295.

[21] Cierniak, M., Timler, D., Wieczorek, A., Sekalski, P., Borkowska, N., & Gaszynski, T. 2016. The comparison of the technical parameters in endotracheal intubation devices: the Cmac, the Vividtrac, the McGrath Mac and the Kingvision. Journal of clinical monitoring and computing, 30, 379-387.

[22] Alvis, B. D., Hester, D., Watson, D., Higgins, M., & St Jacques, P. 2015. Randomized controlled trial comparing the McGrath MAC video laryngoscope with the King Vision video laryngoscope in adult patients. Minerva anestesiologica, 82(1), 30-35.

[23] Erdivanli, B., Sen, A., Batcik, S., Koyuncu, T., & Kazdal, H. 2018. Comparison of King Vision video laryngoscope and Macintosh laryngoscope: a prospective randomized controlled clinical trial. Revista Brasileira de Anestesiologia, 68(5), 499-506