Comparison of VL3 video laryngoscopy with macintosh direct laryngoscopy for endotracheal intubation in paediatric patients.

Endotracheal intubation in children is the most vital and challenging step in securing airway for anaesthesiologists consequent to anatomical and physiological differences from adult airway. Proportionally larger head and tongue, angled vocal cards, long and floppy epiglottis, shorter trachea and neck all contribute to difficulty. Increased Oxygen consumption and reduced functional residual capacity in children contributes to reduced tolerance of apnoea time.

Direct laryngoscope is the most common tool used in securing airway which needs alignment of the oral, pharyngeal and laryngeal axis along the blade to obtain a view for the glottic opening. Any misalignment in the axis results in unexpected poor glottic view requiring manipulation or at times failed intubation.

Video laryngoscope (VLS) is the newest and updated technologies which uses a camera attached to the tip of the blade providing better glottic view without need for axis alignment. VLS has a place in the algorithm of difficult airway management of paediatric patients as an alternative approach to intubation in case of failed attempt by direct laryngoscope.4 Various video laryngoscope available with unique characteristic and advantages, each should be evaluated individually to establish effectiveness.

The VL3 video laryngoscope (HugeMed) is a new portable device for performing endotracheal intubation, weights 350g and has a 3.5 inch display with a 2.0 megapixel camera near tip of the blade and available in neonatal, paediatric and adult sizes in both reusable and disposable version. Hence this study was designed to compare the VL3 video laryngoscope and Macintosh direct laryngoscopy in children between ages 2-8 years in terms of time of intubation.

We hypothesized that the intubation time with VL3 video laryngoscope will be similar to direct laryngoscope but with better glottic view in paediatric patients.