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Updated: Sep 15, 2025

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Comparative Analysis of King Vision aBlade Video Laryngoscopy and Direct Laryngoscopy for Endotracheal Intubation in
Mamta Harjai1, Chaya Devi D2, Sujeet Rai2
1Dr. Ram Manohar Lohia Institute of Medical Sciences, Department of Anaesthesia and Critical Care, Lucknow, Uttar Pradesh, India.
Objective:
Paediatric airway management is challenging due to anatomical differences, making effective endotracheal intubation crucial during surgery. While direct laryngoscopy (DL) has been the standard method, video laryngoscopy (VL) has emerged as a promising alternative. This study compared the effectiveness of King Vision aBlade non-channeled VL (KVL) with Miller/Macintosh DL for intubation in children.
Methods:
In this prospective, randomized, single-blinded study, 150 children aged 2-10 years undergoing elective surgery were randomly assigned to either Group DL (n = 75) or Group KVL (n = 75). Data was collected on intubation success, time, glottic view, external maneuvers, and hemodynamic parameters [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), peripheral oxygen saturation (SpO2)] at various intervals.
Results:
The mean age of patients was similar in both groups (P=0.15). The DL group had a higher success rate on the first attempt (P < 0.001) and shorter intubation times (9.97±3.12 sec vs. 14.35±2.99 sec, P < 0.001) compared to KVL. Although KVL provided a better glottic view, this difference was not statistically significant (P=0.059). Hemodynamic parameters (SBP, DBP) were significantly higher in the DL group post-intubation (P < 0.05), with no significant differences in HR or SpO2 between groups. The DL group required more external maneuvers for intubation (P=0.022).
Conclusion:
DL showed a higher success rate, faster intubation times, and greater hemodynamic stability compared to KVL. While KVL offered better glottic views, it had longer intubation times and lower success rates. Further studies with larger sample sizes are recommended to validate these findings.
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