A comparative evaluation of King Vision video laryngoscope (channelled blade), McCoy, and Macintosh laryngoscopes for tracheal intubation in patients with immobilized cervical spine

Abstract

Background: Cervical spine immobilization results in a poor laryngeal view on direct laryngoscopy leading to difficulty in intubation. This randomized prospective study was designed to compare the laryngeal view and ease of intubation with the Macintosh, McCoy, and King Vision video laryngoscopes in patients with immobilized cervical spine. Method: Ninety adult patients of ASA grade I-II with immobilized cervical spine using manual inline axial cervical spine stabilization technique, undergoing elective cervical surgery were enrolled. The patients were randomly allocated into three groups to achieve tracheal intubation with Macintosh (MAC group n=30), McCoy (MCC group n=30), or King Vision video laryngoscopes (KVL group). When the best possible view of the glottis was obtained, the Cormack-Lehane laryngoscopy grade and the percentage of glottic opening (POGO) score were assessed. Other measurements included the intubation time, the intubation difficulty score, and the intubation success rate. Haemodynamic parameters and any airway complications were also recorded. Result: King Vision video laryngoscope reduced the intubation difficulty score, improved the Cormack and Lehane glottic view, and the POGO score compared with the McCoy and Macintosh laryngoscopes. The first attempt intubation success rate was also high in the King Vision video laryngoscope group. However, there were no statistically significant differences in the time required for successful intubation and the overall success rates between the devices tested. No dental injury or hypoxia occurred with either device. Conclusion: The use of a King Vision video laryngoscope resulted in better glottis visualization, easier tracheal intubation, and higher first attempt success rate as compared to Macintosh and McCoy laryngoscopes in immobilized cervical spine patients.

Comparison of TruView and King Vision video laryngoscopes in subaxial cervical spine injury: A randomized controlled trial

“…Prior studies done by Ali et al . [ 1 ] and Bharti et al .,[ 3 ] respectively, have shown that KV and TV significantly improve laryngoscopic view as compared to Macintosh and McCoy in cervical spine immobilization. We additionally found that KV gives better IDS versus TV EVO2 ( P = 0.0001).…”

Comparison of King Vision video laryngoscope (channeled blade) with Macintosh laryngoscope for tracheal intubation using armored endotracheal tubes

“…Ali et al noticed that increase in HR and mean arterial pressure (MAP) was less with KVVL as compared with the Macintosh laryngoscope. [15] Elhadi et al also found a significant rise in HR and MAP in the Macintosh group compared with the KVVL group. [16] We did not see any significant difference in hemodynamic parameters between the two groups.…”

“…First attempt success rate at intubation was significantly greater in this study, 92 vs 74%, which is in agreement with the study by Ali et al ; however, Elhadi et al did not find any significant difference. [1516]…”

A prospective crossover study evaluating the efficacy of king vision video laryngoscope in patients requiring general anesthesia with endotracheal intubation

“…A study by Ali et al . [2] has shown an improvement in the Cormack–Lehane grade using the King Vision laryngoscope compared with the Macintosh laryngoscope. Our study also is in keeping with the observations made by Ali et al .…”

“…The nonchanneled blade, which we used in this study, requires a minimum of 13-mm mouth opening and thus may be potentially useful in patients with limited mouth opening. [2]…”