Video laryngoscopy for pediatric intubation, compared to classic orotracheal intubation. Original Research

Abstract

Introduction: Airway management is an important aspect of pediatric anesthesia. Anatomical differences in this population make pediatric patients more susceptible to the devices that are designed for their management. Videolaryngoscopy provides an improved panoramic view of the glottis. The aim of the present study was to compare the use of video laryngoscopy to direct laryngoscopy for endotracheal intubation in pediatric patients.

Methods: Using an observational descriptive study design, 276 patients (aged 5 to 17 years) who were undergoing planned surgery with general anesthesia plus orotracheal intubation were enrolled. The specialist determined the handling device that was used. The data were transcribed from the forms and analyzed using SPSS 22.0. Descriptive analysis was based on the median, mode, average, and minimum and maximum values as well as the standard deviation and range. A p value ≤ 0.05 was considered to be statistically significant.

Results: The patients’ mean age was 9.83 years. With direct laryngoscopy or videolaryngoscopy, 97.4% or 88.4% of the intubations were performed on the first attempt (P=0.003). In 94.2% of direct laryngoscopy cases and 75.2% of laryngoscope cases, successful intubation was performed in less than 10 seconds (P<0.001). Complications occurred in 6.6% of intubations with video laryngoscopy compared to 2.6% with conventional laryngoscopy (P=0.103). Additionally, 56.2% of specialists preferred direct laryngoscopy compared to videolaryngoscopy to manage a pediatric airway without predictors of difficulty.

Conclusions: Videolaryngoscopy provides additional support for routine airway management, and it requires previous knowledge and skill. However, there is insufficient evidence to support the use of one technique over the other.