Intubation metrics and clinical outcomes using king vision versus CMAC-D blade video laryngoscope in head and neck surgical airways

Background: Video laryngoscope (VLs) has become a mandate in airway management. Every VLs have a unique design that warrants the need for intricate analysis and research concerning its efficacy. Aims and Objectives: This prospective randomized controlled trial was designed to compare the performance of channeled King Vision VLs (KVVLs) and hyperangulated CMAC-D blades for endotracheal intubation in head and neck surgeries. Materials and Methods: Institutional Ethical Clearance and Clinical Trials Registry-India registration were obtained. Informed consent of 110 patients of American Society of Anesthesiologists classification I and II, aged between 18 and 59 years of either gender was taken, and was randomly allocated into two groups. Standard induction for general anesthesia was given. Patients were intubated using either of two VLs. The primary outcome was mean time taken for intubation, and secondary outcomes were ease of intubation by intubation difficulty scoring, hemodynamic response following laryngoscopy, intubation, and their associated complications. Results: The total time taken for intubation was comparable between both KVVLs and CMAC-D blade (30.45±6.53 s, 27.85±9.04 s; P=0.087). Glottic visualization by percentage of glottic opening scoring was significantly better with the CMAC-D blade (P=0.049). The need for assist maneuvers and alternate techniques was more required by KVVLs than CMAC-D blades (P=0.004 and 0.028, respectively). The intergroup hemodynamic variables and complications associated with laryngoscopy were not statistically significant. Conclusion: Both KVVLs and CMAC-D blades were equally efficient in managing the airway in head and neck surgeries. KVVLs offer practical advantages making it ideal for resource-limited settings, with its performance remaining uncompromised even in absence of a CMAC-D blade.