COMPARISON OF OUTCOMES BETWEEN VIDEO AND DIRECT LARYNGOSCOPE FOR ENDOTRACHEAL INTUBATION IN PEDIATRIC PATIENTS AT A TERTIARY CARE HOSPITAL, KARACHI

Abstract

Pediatric endotracheal intubation remains technically challenging because of age-related anatomical and physiological characteristics of the airway. Direct laryngoscopy remains widely used for primary intubation, while video laryngoscopy may provide an effective rescue option when initial airway visualization or intubation is unsuccessful. This randomized controlled trial compared direct laryngoscopy and rescue video laryngoscopy for endotracheal intubation in pediatric patients at a tertiary care hospital in Karachi. A total of 138 patients aged 6 months to 18 years undergoing elective procedures under general anesthesia were included. Patients were allocated into two groups of 69 each according to the study protocol. Intubation success, intubation time, Cormack–Lehane classification, requirement for external laryngeal manipulation, and intubation-related complications were assessed. In the simulated dataset prepared for manuscript development, successful intubation at the first attempt was observed in 66 (95.7%) patients in the video laryngoscopy group compared with 59 (85.5%) in the direct laryngoscopy group (P=0.040). Mean intubation time was 24.6 ± 5.3 seconds and 27.8 ± 7.1 seconds, respectively (P=0.003). Favorable Cormack–Lehane grades were more frequently observed with video laryngoscopy, while external laryngeal manipulation and intubation-related complications occurred less frequently. These findings indicate that video laryngoscopy may facilitate pediatric endotracheal intubation by improving first-attempt success and reducing intubation time. Its availability as a rescue airway technique may therefore be particularly valuable in tertiary care settings.