Comparative Evaluation of Videolaryngoscopy and Direct Laryngoscopy Performed in Paediatric Patients Undergoing...

Paediatric airway management poses unique challenges due to anatomical and physiological differences compared to adults. Videolaryngoscopy (VL) has been proposed as a potential improvement over direct laryngoscopy (DL) for tracheal intubation. This study aimed to compare VL and DL in paediatric patients undergoing elective surgery.

A prospective, randomized study was conducted with 100 paediatric patients aged under 18 years, weighing 10-40 kg, and classified as American Society of Anesthesiologists physical status I-III. Patients were randomized into Group 1 (n = 50) that included patients who underwent laryngoscopic examination using Macintosh laryngoscope or Endolarenx videolaryngoscope (Group 2: n = 50). Data on intubation time, glottic view (Cormack-Lehane grades), first-attempt success rate, need for anterior laryngeal pressure, and complications were collected.

VL was associated with longer intubation time than DL (29.1±5.7 s vs. 20.7±5.1 s, P=0.001). Glottic visualization was better in the VL group (Cormack-Lehane Grade 1: 78% vs. 66%), but first-attempt success rate was lower (74% vs. 98%, P < 0.001). The need for anterior laryngeal pressure was significantly reduced in VL (32% vs. 78%, P=0.01). No complications, such as trauma or hypoxaemia, were observed in either group.

VL improves glottic visualization and reduces the need for airway maneuvers but is associated with longer intubation times and lower first-attempt success. While DL may be more efficient for routine intubation, VL remains valuable in anticipated or emergent difficult airway situations.