Skip to main content
SpringerLink
Log in

Comparative evaluation of King Vision videolaryngoscope channeled and non-channeled blades with direct laryngoscope for intubation performance and skill retention by medical students: a randomized cross over two period study

  • Original Research
  • Published:
Journal of Clinical Monitoring and Computing Aims and scope Submit manuscript

Abstract

Purpose: A videolaryngoscope(VL) with an intubation conduit like KingVision channeled(KVC) blade may provide an added advantage over a non-channeled VL like a KingVision non-channeled (KVNC) blade and direct laryngoscope (DL) for acquiring and retention of intubation skills, especially in novices. Methods: In this prospective two-period randomized crossover trial, one hundred medical students used three laryngoscopes KVC, KVNC and DL for intubation following standardized training with the study devices using a Laerdal Airway Management Trainer. After one month, all participants attempted intubation, in the same manner, using all devices. The duration of intubation, modified Cormack-Lehane (CL) grade, percentage of glottic opening (POGO) score, first-attempt success, number of attempts, ease of intubation and dental trauma was recorded. The retention of intubation skills after 1 month was also assessed on the same parameters. Results: Median intubation times of KVC and DL were comparable and significantly better than KVNC (P < 0.001). The median POGO score was better with both videolaryngoscopes when compared with DL. The ease of intubation (P < 0.0012) and first-attempt success rate (P = 0.001) at the time ‘0’ was significantly better with KVC compared to KVNC and DL. KVC fared better with respect to these intubation parameters during intubation after one month as well. Conclusion: KVC performed better in terms of time to intubation, success rate and ease of procedure as compared to KVNC and DL, both for acquisition and retention of skill. Hence, we advocate that KVC should be the preferred device over KVNC and DL for teaching intubation skills to novices.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Mulcaster JT, Mills J, Hung OR, et al. Laryngoscopic intubation: learning and performance. Anesthesiology. 2003;98:23–37. https://doi.org/10.1097/00000542-200301000-00007.

    Article  PubMed  Google Scholar 

  2. Arulkumaran N, Lowe J, Ions R, Mendoza M, Bennett V, Dunser MW. Videolaryngoscopy versus direct laryngoscopy for emergency orotracheal intubation outside the operating room: a systematic review and meta-analysis. Br J Anaesth. 2018;120:712–24. https://doi.org/10.1016/j.bja.2017.12.041.

    Article  CAS  PubMed  Google Scholar 

  3. Griesdale DE, Bosma TL, Kurth T, Isac G, Chittock DR. Complications of endotracheal intubation in the critically ill. Intensive Care Med. 2008;34:1835–42. https://doi.org/10.1007/s00134-008-1205-6.

    Article  PubMed  Google Scholar 

  4. Van Zundert A, Pieters B. Videolaryngoscopy: the new standard for intubation. Ten years’ experience. Minerva Anestesiol. 2015;81:1159–62.

    PubMed  Google Scholar 

  5. Griesdale DEG, Liu D, McKinney J, Choi PT. Glidescope® video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysis. Can J Anaesth. 2012;59:41–52. https://doi.org/10.1007/s12630-011-9620-5.

    Article  PubMed  Google Scholar 

  6. Cooper RM, Pacey JA, Bishop MJ, McCluskey SA. Early clinical experience with a new videolaryngoscope (GlideScope) in 728 patients. Can J Anaesth. 2005;52:191–98. https://doi.org/10.1007/BF03027728.

    Article  PubMed  Google Scholar 

  7. Pieters BM, Wilbers NE, Huijzer M, Winkens B, van Zundert AA. Comparison of seven videolaryngoscopes with the Macintosh laryngoscope in manikins by experienced and novice personnel. Anaesthesia. 2016;71:556–64. https://doi.org/10.1111/anae.13413.

    Article  CAS  PubMed  Google Scholar 

  8. Okada D, Komasawa N, Fujiwara S, Minami T. Comparison of tube-guided and guideless videolaryngoscope for tracheal intubation during chest compression in a manikin: a randomized crossover trial. J Anesth. 2015;29:331–7. https://doi.org/10.1007/s00540-014-1936-1.

    Article  PubMed  Google Scholar 

  9. Chew SH, Lim JZM, Chin BZB, Chan JX, Siew RCH. Intubation with channeled versus non-channeled video laryngoscopes in simulated difficult airway by junior doctors in an out-of-hospital setting: A crossover manikin study. PLoS ONE. 2019;14:e0224017. https://doi.org/10.1371/journal.pone.0224017.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Rendeki S, Keresztes D, Woth G, et al. Comparison of VividTrac®, Airtraq®, King Vision®, Macintosh Laryngoscope and a Custom-Made Videolaryngoscope for difficult and normal airways in mannikins by novices. BMC Anesthesiol. 2017;17:68. https://doi.org/10.1186/s12871-017-0362-y.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Narang AT, Oldeg PF, Medzon R, Mahmood AR, Spector JA, Robinett DA. Comparison of intubation success of video laryngoscopy versus direct laryngoscopy in the difficult airway using high-fidelity simulation. Simul Healthc. 2009;4:160–5. https://doi.org/10.1097/SIH.0b013e318197d2e5.

    Article  PubMed  Google Scholar 

  12. Frerk C, Mitchell VS, McNarry AF, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015;115:827–48. https://doi.org/10.1093/bja/aev371.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Apfelbaum JL, Hagberg CA, Caplan RA, et al. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2013;118:251–70. https://doi.org/10.1097/ALN.0b013e31827773b2.

    Article  PubMed  Google Scholar 

  14. Bakshi SG, Vanjari VS, Divatia JV. A prospective, randomised, clinical study to compare the use of McGrath®, Truview® and Macintosh laryngoscopes for endotracheal intubation by novice and experienced Anesthesiologists. Indian J Anaesth. 2015;59:421–27. https://doi.org/10.4103/0019-5049.160946.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Murphy LD, Kovacs GJ, Reardon PM, Law JA. Comparison of the king vision video laryngoscope with the Macintosh laryngoscope. J Emerg Med. 2014;47:239–46. https://doi.org/10.1016/j.jemermed.2014.02.008.

    Article  PubMed  Google Scholar 

  16. Valencia JA, Pimienta K, Cohen D, Benitez D, Romero D, Amaya O, et al. A comparison of King Vision video laryngoscopy and direct laryngoscopy as performed by residents: a randomized controlled trial. J Clin Anesth. 2016;35:571–75. https://doi.org/10.1016/j.jclinane.2016.07.039.

    Article  PubMed  Google Scholar 

  17. Reena. Comparison of King Vision video laryngoscope (channeled blade) with Macintosh laryngoscope for tracheal intubation using armored endotracheal tubes. J Anaesthesiol Clin Pharmacol. 2019;35:359–62. https://doi.org/10.4103/joacp.JOACP_43_18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hirabayashi Y. Airway Scope versus Macintosh laryngoscope: a manikin study. Emerg Med J. 2007;24:357–58. https://doi.org/10.1136/emj.2006.045013.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Nouruzi-Sedeh P, Schumann M, Groeben H. Laryngoscopy via Macintosh blade versus GlideScope: success rate and time for endotracheal intubation in untrained medical personnel. Anesthesiology. 2009;110:32–7. https://doi.org/10.1097/ALN.0b013e318190b6a7.

    Article  PubMed  Google Scholar 

  20. Sakles JC, Mosier JM, Chiu S, Keim SM. Tracheal intubation in the emergency department: a comparison of GlideScope® video laryngoscopy to direct laryngoscopy in 822 intubations. J Emerg Med. 2012;42:400–5. https://doi.org/10.1016/j.jemermed.2011.05.019.

    Article  PubMed  Google Scholar 

  21. Su Y-C, Chen C-C, Lee Y-K, Lee J-Y, Lin KJ. Comparison of video laryngoscopes with direct laryngoscopy for tracheal intubation: a meta-analysis of randomized trials. Eur J Anaesthesiol. 2011;28:788–95. https://doi.org/10.1097/EJA.0b013e32834a34f3.

    Article  PubMed  Google Scholar 

  22. Maharaj CH, McDonnell JG, Harte BH, Laffey JG. A comparison of direct and indirect laryngoscopes and the ILMA in novice users: a manikin study. Anaesthesia. 2007;62:1161–6. https://doi.org/10.1111/j.1365-2044.2007.05216.x.

    Article  CAS  PubMed  Google Scholar 

  23. Lee J, Cho Y, Kim W, Choi KS, et al. Comparisons of Videolaryngoscopes for Intubation Undergoing General Anesthesia: Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. J Pers Med. 2022;12:363. https://doi.org/10.3390/jpm12030363.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Lee RA, van Zundert AAJ, Maassen RLJG, et al. Forces Applied to the Maxillary Incisors During Video-Assisted Intubation. Anesth Analg. 2009;108:187–91. https://doi.org/10.1213/ane.0b013e31818d1904.

    Article  PubMed  Google Scholar 

  25. Hunter I, Ramanathan V, Balasubramanian P, Evans DA, Hardman JG, McCahon RA. Retention of laryngoscopy skills in medical students: a randomised, cross-over study of the Macintosh, A.P. Advance (™), C-MAC (®) and Airtraq (®) laryngoscopes. Anesthesia. 2016; 71:1191–97. https://doi.org/10.1111/anae.13589.

Download references

Acknowledgements

Assistance with the article: None. Financial support and sponsorship: This study received a fund of rupees 2 lakhs by AIIMS for the undergraduate mentorship program ( UG-16) in the year 2019.

Author information

Authors and Affiliations

  1. Department of Onco-Anesthesia and Palliative Medicine, DRBRAIRCH, AIIMS, New Delhi, India

    Nishkarsh Gupta & Riniki Sarma

  2. AIIMS, Delhi, India

    Pranjal Kabra & Subro Mandal

  3. Department of Anesthesia, Pain Medicine, and Critical Care, AIIMS, New Delhi, India

    Anju Gupta

  4. Delhi Cancer Registry, DRBRAIRCH, AIIMS, Room No. 6, 4th Floor, Porta Cabin, Teaching Block, India

    Rajeev Kumar Malhotra

  5. Department of Anesthesiology, Pain Medicine and Critical care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

    Anju Gupta

Authors
  1. Nishkarsh Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pranjal Kabra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Subro Mandal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anju Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Riniki Sarma
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rajeev Kumar Malhotra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anju Gupta.

Ethics declarations

Conflict of interest

None.

Trial registration

CTRI no: CTRI/2019/10/021682.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gupta, N., Kabra, P., Mandal, S. et al. Comparative evaluation of King Vision videolaryngoscope channeled and non-channeled blades with direct laryngoscope for intubation performance and skill retention by medical students: a randomized cross over two period study. J Clin Monit Comput 37, 541–547 (2023). https://doi.org/10.1007/s10877-022-00919-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10877-022-00919-w

Keywords

Search

Navigation