Video Laryngoscopy Found Most Effective Method for Intubating Patients Undergoing Surgical Procedures

Endotracheal tubes are usually placed in the operating room through a process called direct laryngoscopy. Video laryngoscopy, which uses a video camera to visualize the airway structures better, helps place these tubes. While it's known that video laryngoscopy improves the view of the airway, it is still uncertain if it also reduces the number of attempts needed to insert the tube in patients undergoing surgery. Now, new research shows that video laryngoscopy does reduce the number of attempts to successfully insert the tube in adult patients needing a single-lumen endotracheal tube for general anesthesia, as compared to direct laryngoscopy.

This largest-of-its-kind study by Cleveland Clinic (Cleveland, OH, USA), compared the effectiveness of hyperangulated video laryngoscopy with direct laryngoscopy in patients needing single-lumen endotracheal intubation under general anesthesia. The study involved 8,429 surgical procedures on 7,736 patients and found a notable decrease in the number of tries to insert the tube with video laryngoscopy compared to direct laryngoscopy. Specifically, 1.7% of patients requiring more than one attempt fell in the group that used video laryngoscopy, while 7.6% of patients needed more than one attempt with direct laryngoscopy.

“Securing airways is a priority for anesthesiologists, surgeons, critical care and emergency physicians,” said Kurt Ruetzler, M.D., an anesthesiologist at Cleveland Clinic, who led the research. “Successful and timely attempts to intubate greatly decrease poor outcomes such as respiratory and hemodynamic complications, including hypoxemia, aspiration, airway trauma and even cardiac arrest.”

"This is the largest airway trial ever performed,” Dr. Ruetzler added. “This trial is going to change clinical practice, as results clearly indicate that video laryngoscopy is superior to direct laryngoscopy and should be the default device in all patients.”

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