Evaluation of the use of the channeled King Vision video laryngoscope in improving glottic visualisation in patients with limited glottic view with the Macintosh laryngoscope: A prospective observational study

Abstract

Background and Aims: The role of King Vision videolaryngoscope (KVL) is well known in the anticipated difficult airway. However, its performance in patients with unanticipated restricted view of the glottis has never been investigated. The aim of this study was to evaluate the performance of KVL in patients with limited glottic view (POGO score <50%). Methods: Eighty-five patients fulfilling the inclusion criteria were included in this study. Laryngoscopy was performed in each patient with Macintosh blade followed by the channeled KVL. The laryngeal view obtained with each device was recorded using POGO score and Cormack--Lehane (CL) grade. After that, endotracheal intubation was attempted with the KVL. The haemodynamic parameters, the time taken for endotracheal tube placement and intubation, failure to intubate, modified intubation difficulty score and airway complications were also recorded. Results: There was a statistically significant improvement in the POGO scores with the use of KVL: 20 (0,40) vs 90 (40,100) (P < 0.001). The frequency of CL grade I and II increased from 63% with conventional laryngoscopy to 100% with the KVL. Although the time taken to obtain the best glottic view was significantly longer with the KVL as compared to the Macintosh blade (P < 0.001), the first attempt success rate was 97.65%. Conclusion: Channeled KVL when used by experienced operators provides superior laryngeal view as compared to Macintosh laryngoscope in patients with restricted glottic view (POGO score <50%) without any major airway complications.

Keywords

• airway management
• endotracheal intubation
• laryngoscope