Aim of review:The aim of this article is to review the recent literatures regarding videolaryngoscopes, compare performance of videolaryngoscopy versus direct laryngoscopy, discuss the role of videolaryngoscopy in clinical airway management and provide the measures that can improve the performance of videolaryngoscopy and decrease complications associated with videolaryngoscopy. Methods: The literatures about the use of videolaryngoscopes in the clinical airway management, published in the past decades, were searched from the Pubmed and Cochrane databases and reviewed, in order to determine their performance, and identify their limitations and find appropriate alternate techniques to overcome their shortcomings and failures. Recent findings: Videolaryngoscopes are promising intubation devices, which are easy to use, and the skills involved are easy to obtain by either novices or experienced intubators. In the current practice, videolaryngoscopes are commonly used as main devices of predicted difficult airways and as rescue tools of difficult or failed direct laryngoscopy. For patients with difficult airways, videolaryngoscopy can provide an improved laryngeal visualization and achieve a higher intubation success rate compared with direct laryngoscopy. Moreover, videolaryngoscopy has the potential to increase patient safety by facilitating learning, teaching, and success of tracheal intubation. Despite the very good laryngeal visualization, the insertion and advancement of the tracheal tube with videolaryngoscopy may occasionally fail, and the airway injuries associated with videolaryngoscopy can occur. Summary: The introduction of videolaryngoscopy has resulted in a dramatic transformation of clinical airway management and is seen as the evolutionary step in intubation technology. There are several different types of videolaryngoscopes available. Each device's features may offer advantages or disadvantages, depending on the situation the anesthetist has to deal with. To get the best out of videolaryngoscopy, all anesthetists must be trained in the use of videolaryngoscopes and such devices should be available in all sites where tracheal intubation is performed.

The C-MAC videolaryngoscope is the first Macintosh-typed videolaryngoscope. Since the advent of its original version video Macintosh system in 1999, this device has been modified several times. A unique feature of C-MAC device is its ability to provide the 2 options of direct and video laryngoscopy with the same device. The available evidence shows that in patients with normal airways, C-MAC videolaryngoscope compared with direct laryngoscopy can provide comparable or better laryngeal views and exerts less force on maxillary incisors, but does not offer conclusive benefits with regard to intubation time, intubation success, number of intubation attempts, the use of adjuncts, and hemodynamic responses to intubation. In patients with predicted or known difficult airways, C-MAC videolaryngoscope can achieve a better laryngeal view, a higher intubation success rate and a shorter intubation time than direct laryngoscopy. Furthermore, the option to perform direct and video laryngoscopy with the same device makes C-MAC videolaryngoscope exceptionally useful for emergency intubation. In addition, the C-MAC videolaryngoscope is a very good tool for tracheal intubation teaching. However, tracheal intubation with C-MAC videolaryngoscope may occasionally fail and introduction of C-MAC videolaryngoscope in clinical practice must be accompanied by formal training programs in normal and difficult airway managements.

Objective:UEscope is a new angulated videolaryngoscope (VL). This review aimed to describe the features of UEscope and provide clinical evidences regarding the efficacy and safety of this video device in adult tracheal intubation and its roles in airway management teaching.Data Sources:The Wan Fang Data, CNKI, PubMed, Embase, Cochrane Library, and Google Scholar were searched for relevant English and Chinese articles published up to January 15, 2017, using the following keywords: “HC video laryngoscope”, “UE videolaryngoscope”, “video laryngoscope”, and “videolaryngoscopy”.Study Selection:Human case reports, case series, observable studies, and randomized controlled clinical trials were included in our search. The results of these studies and their reference lists were cross-referenced to identify a common theme.Results:UEscope features the low-profile portable design, intermediate blade curvatures, all-angle adjustable monitor, effective anti-fog mechanisms, and built-in video recording function. During the past 5 years, there have been a number of clinical studies assessing the application and roles of UEscope in airway management and education. As compared with direct laryngoscope, UEscope improves laryngeal visualization, decreases intubation time (IT), and increases intubation success rate in adult patients with normal and difficult airways. These findings are somewhat different from the previous results regarding the other angulated VLs; they can provide an improved laryngeal view, but no conclusive benefits with regard to IT and intubation success rate. Furthermore, UEscope has extensively been used for intubation teaching and shown a number of advantages.Conclusions:UEscope can be used as a primary intubation tool and may provide more benefits than other VLs in patients with normal and difficult airways. However, more studies with large sample are still needed to address some open questions about clinical performance of this new VL.