Video Laryngoscopy Versus Direct Laryngoscopy in Novices: A Randomized Clinical Trial

Intubating the trachea is a challenging task, especially for novice intubators. Successful intubation, in the shortest possible time, prevents hypoxia and hemodynamic disturbances. During the last few decades, video laryngoscopy has proven to be a helpful tool for intubating patients successfully, especially in difficult cases. However, novices must be proficient with a video laryngoscopy. It is not entirely clear which method, direct laryngoscopy or video laryngoscopy, is more successful for tracheal intubation in individuals who have recently started their airway management training. In this study, we aim to investigate this issue. 150 patients were randomly assigned to either direct laryngoscopy or video laryngoscopy by first-year anesthesia assistants. Intubation time, intubation success rate, Cormack-Lehane score, and instances of using the Optimal external laryngeal manipulation (OELM) maneuver, were recorded. The rate of successful intubation was higher in the direct laryngoscopy group, and the time taken was less. The direct laryngoscopy provided a better view of the glottis than the video laryngoscopy, although this difference was not statistically significant. Direct laryngoscopy resulted in a higher frequency of OELM. Based on our study, the success rate and speed of intubation in novices were higher with direct laryngoscopy compared to video laryngoscopy.