Introduction: Airway management of infants is challenging, and video laryngoscopes can help reduce intubation attempts and improve glottic visualization. In this study, we compared the Besdata video laryngoscope with the Miller laryngoscope in neonates and infants 6 months of age.
Methods: After obtaining informed written consent from the parents, we randomized 80 infants scheduled for elective surgery requiring endotracheal intubation into two groups, Group DL and Group VL. We used a direct laryngoscope with a Miller blade in group DL and a Besdata video laryngoscope with a Miller blade in group VL. We compared the time taken for intubation, glottis visualization time, percentage of glottic opening (POGO) score, Cormack Lehane (CL) grades, first attempt success rate, need for external laryngeal manipulation, and complications between the two groups.
Results: The median (interquartile range, IQR) time taken for intubation was 36.0 s (30.5-39.0) versus 35.0 s (28.0-40.0) (p = 0.35), similar in both groups. The median difference (95% confidence interval, CI) was 0.0 s [-4.0 to 5.0]. The median (IQR) time for glottic visualization was 13.0 s (10.0-15.5) versus 10.0 s (8.0-12.0), and the median difference (95% CI) was 2.0 s [1-6] in group DL and group VL, respectively, showing shorter time with a video laryngoscope. We also found better POGO scores and decreased need for optimal external laryngeal manipulation with a Besdata video laryngoscope. The first attempt intubation success rate, use of bougie, and complications were similar in both groups.
Conclusion: The Besdata video laryngoscope with a zero-size Miller blade has shown a similar intubation time when compared with a conventional laryngoscope in neonates and infants of 6 months of age. The first attempt intubation success rate was also comparable between the two groups. However, the Besdata video laryngoscope is associated with comparatively better glottic visualization.
Trial Registration: Clinical Trial Registry of India (CTRI; www.ctri.nic.in): CTRI/2021/012/038787.
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