A COMPARATIVE STUDY OF VIDEO-ASSISTED LARYNGOSCOPY VERSUS CONVENTIONAL MACINTOSH LARYNGOSCOPY IN ELECTIVE SURGERIES: EFFICACY, INTUBATION SUCCESS RATES, AND COMPLICATIONS

Abstract

Objective: The Macintosh laryngoscope has long been the conventional tool for endotracheal intubation in general anaesthesia; however, video-assisted laryngoscopy (VAL) offers improved glottic visualisation. This study compared the observed efficacy and safety of VAL versus Macintosh laryngoscopy in patients with normal airways undergoing elective surgery.

Study Design and Setting: A prospective, comparative observational study was conducted in 200 ASA I–II adult patients scheduled for elective procedures. Based on clinical preference and device availability, participants were intubated using either VAL (C-MAC/McGrath) or Macintosh laryngoscope. Primary outcome was first-attempt intubation success. Secondary outcomes included intubation time, Cormack–Lehane grade, hemodynamic changes, and complications.

Methodology: Data were prospectively collected on consecutive patients meeting the inclusion criteria. To minimize bias, data collection and analysis were performed by investigators blinded to the study groups during outcome assessment. Parameters recorded included intubation success, time to intubation, glottic view, hemodynamic parameters, and postoperative complications.

Results: First-attempt success was significantly higher with VAL (98%) compared to Macintosh laryngoscopy (84%) (p < 0.001). A Cormack–Lehane grade I view was achieved more frequently with VAL (96% vs. 78%, p < 0.001). Intubation time was shorter with Macintosh laryngoscopy (18.2 ± 5.1 seconds vs. 22.8 ± 6.7 seconds, p < 0.001). Hemodynamic responses were similar between groups. Postoperative sore throat occurred less often in the VAL group (8% vs. 20%, p = 0.01).

Conclusion: In this study, the use of VAL was associated with superior first-attempt success and glottic visualization compared with Macintosh laryngoscopy, though intubation time was slightly longer. VAL was associated with fewer minor complications. These observational findings support its role as a safe and effective alternative for routine airway management, meriting consideration for broader clinical adoption.