[Value of video laryngoscopy as universal primary intubation technique for anesthesiological practice : Narrative...

According to data from the World Health Organization (WHO), approximately 300 million surgical procedures are performed worldwide each year. The majority of these procedures are conducted with the patient under general anesthesia, with endotracheal intubation used to secure the airway in more than half of the cases. Complications during airway management can lead to serious adverse events and significantly contribute to perioperative morbidity and sometimes even mortality.Over the past 25 years, the increasing use of video laryngoscopes in clinical practice has led to substantial advancements in the management of difficult airways. This has resulted in a marked reduction in potentially severe complications, establishing video laryngoscopes as an indispensable tool in modern anesthesia practice; however, a critical question remains: why has video laryngoscopy become the standard approach for anticipated and unanticipated difficult airways but is not (yet) routinely employed as the primary method for all intubations?Both meta-analyses and randomized controlled trials have confirmed the superiority of video laryngoscopy in airway management across various patient populations and clinical scenarios. Video laryngoscopy improves the first attempt success rate of intubation, while simultaneously reducing the total number of intubation attempts, the incidence of airway injuries and the rate of failed intubations. Consequently, in alignment with the current German S1 guidelines on airway management, the adoption of video laryngoscopy as a potential standard technique for all intubations is recommended.The benefits of video laryngoscopy clearly outweigh the arguments against its universal application. It should therefore be adopted as the primary intubation technique in order to enhance patient safety and improve the overall quality of airway management.