Effect of Cricoid Pressure on the Glottic View and Intubation with King Vision(®) Video Laryngoscope

CONTEXT: To establish the usefulness of King Vision(®) video laryngoscope (KVL) in patients with rapid sequence anesthesia. AIMS: This study aims to compare the role of KVL on glottic visualization, intubation time and associated sympathetic response in routine intubations to those intubations done with cricoid pressure (CP). SETTINGS AND DESIGN: Randomized controlled study in a tertiary care hospital. METHODOLOGY: Seventy-six patients intubated with KVL were randomized to two groups – Group C (who did not receive any CP) and Group CP – who received CP. The percentage of glottic opening (POGO), intubation time, subjective assessment, and number of attempts taken to introduce KVL and endotracheal tube (ETT) were noted. The saturation, end-tidal carbon dioxide concentration and hemodynamic response (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and rate pressure product) in the peri-intubation period were also recorded. RESULTS: The demographics, airway, and technical characteristics of insertion of KVL and ETT were comparable between the groups (P > 0.05). POGO score was 100% in both groups. The significant time in insertion of KVL (Group C 29.87 ± 11.64 s and Group CP 40.68 ± 18.93 s, P = 0.004) and ETT (Group C 17.53 ± 8.71 s and Group CP 22.42 ± 10.77 s, P = 0.033) contributed to prolonged overall intubation time in CP (Group C 41.11 ± 11.65 s and Group CP 51.05 ± 17.31 s, P = 0.005). The intergroup and intragroup hemodynamic variables did not show any statistical significance (P > 0.05) over time. CONCLUSION: Although overall intubation time with KVL is prolonged in patients with CP, it provides excellent glottic view, eases intubation, and causes insignificant hemodynamic variation.