The Comparison of Video Fiberscope and DCI Video Laryngoscope Performed by Two Practitioners in Patients with an EGRi Score of >4: A Single-Blind, Prospective, Randomized Study

Abstract

Objective: Endotracheal intubation is central to the practice of general anesthesia. Complications can be prevented by using alternative airway devices in difficult intubation cases. In this study, we compared the results of endotracheal intubation with video fiberscope and direct-coupled interface (DCI) video laryngoscope devices performed by an experienced (E) and inexperienced (H) practitioner. Methods: This single-blind, prospective, randomized study included 60 patients with an El-Ganzouri risk index score of >4 and American Society of Anesthesiologists score of <4 who were operated between October 1, 2018 and March 1, 2019, in the operating room of the Ondokuz Mayis University Medical Faculty Hospital. Endotracheal intubation was performed by two practitioners using two different devices (video fiberscope and DCI video laryngoscope). Intubation times, a number of attempts, failed attempts, postoperative complications and haemodynamic responses were recorded. Results: There were no significant differences between demographic data, the number of attempts, unsuccessful attempts, postoperative complications and haemodynamic data between the groups. In the DCI video laryngoscope group, time to intubation was significantly shorter by the E practitioner than that the H practitioner (p=0.047). The E practitioner performed intubation DCI video laryngoscope in a statistically significantly shorter time than using a video fiberscope (p=0.014). Conclusion: In our study, unlike other studies in the literature, endotracheal intubation was performed with two different devices by two E and H practitioners in difficult intubation cases. We saw that the E practitioner provided endotracheal intubation in a shorter time with the DCI video laryngoscope compared to the video fiberscope and in a shorter time than the H practitioner. We believe that the comparison of two devices under different difficult intubation conditions by different practitioners may give a different perspective to the studies in the literature.