Comparison of the Vocal Cord Views Using the Classical Miller, Wis-Hipple and C-MAC Straight Size 1 Blades in Young Children

This will be a prospective, randomized, blinded study. The primary objective is to compare straight blades in obtaining best vocal cord view in children. The secondary objectives will be to determine the subjective ease of laryngoscopy and intubation, desaturation and complications with each blade and to compare the view of the CMAC with a photo of the direct view with the CMAC blade.

In this study, the investigators will compare three different straight blades used in pediatric anesthesia: Miller blade size 1, Wis-Hipple blade size 1, and C-MAC straight blade size 1.

The sample size was estimated in this equivalence study assuming an alpha two-tailed of 0.05, beta of 0.2, proportion with a POGO score > 80 with the Miller blade (based on the results of our previous study) of 0.64 and an estimated proportion of 0.74 with the Wis-Hipple blade in the present study. The hypothesized difference required to reject equivalence is ≥ 0.2. This requires 96 children in total or 32 children per group. To account for un-interpretable photos and dropouts, we enrolled 101 children.

One hundred and one children who were eligible to participate will be consented, randomized, and allocated to one of the three study groups after consent is obtained from the parents/ guardian during regular anesthesia pre-operative evaluation. According to randomization children will be assigned to one of three groups:

Group A- Laryngoscopy by classical Miller blade, size 1 Group B- Laryngoscopy by Wis-Hipple blade, size 1 Group C- Laryngoscopy by C-MAC Miller blade, size 1.