Intubation Learning Curve with the HugeMed Video Laryngoscope among Anesthesiology Postgraduate Students: An Observational Study

Abstract

Background: Video laryngoscopy (VL) facilitates intubation by providing an indirect view of the glottis. To determine VL intubation success, establishing its learning curve is important. This study aimed to evaluate the learning curve of VL intubation in anesthetized patients, performed by anesthesiology postgraduate (PG) students. Materials and Methods: Thirty-six anesthesiology PGs with a direct laryngoscopic (DL) intubation experience of >1 year, but new to VL, participated in this study. Each PG performed five VL intubations in anesthetized patients having normal airways (total 180 VL intubations). The primary outcome variable was intubation time, and the secondary outcome measures were first attempt success rate and difficulties encountered. Results: Mean intubation time decreased significantly from the first VL experience [57.81 s (95% CI 52.09–63.54)] to the fifth VL experience [24.14 s (95% CI 22.28–25.99)], P < 0.001. The first attempt success rate showed a significant increase from 83.3% (n = 30) in the first, 97.2% (n = 35) in the second, and 100% (n = 36) in the next three VL experiences (P < 0.001). The incidence of difficulty in laryngoscopy and endotracheal tube (ETT) insertion progressively decreased in successive VL experiences, and by the fifth VL experience, none of them faced any difficulty (P < 0.001). Conclusion: The learning curve of VL intubation showed a significant reduction in intubation time and improvement in the first attempt success rate over successive experiences, emphasizing the need for prior training even if the user is familiar with the process of DL intubation.

Keywords

• anesthesiology; intubation; laryngoscopy; learning curve