Macintosh laryngoscope versus AMBU King Vision video laryngoscope for endotracheal intubation using a COVID-19 barrier box: A randomized controlled trial

BACKGROUND: Coronavirus disease 2019 (COVID-19) barrier box is being used by health-care workers for protection against aerosol-transmitted infection. Usually, a Macintosh laryngoscope (MC) or a video laryngoscope (VL) is used for endotracheal intubation (ETI). We aimed to determine the most suitable laryngoscope blade in terms of time to ETI, ease of ETI, and the first-pass success rate. METHODS: American Society of Anesthesiologists Grade I and II patients undergoing surgery under general anesthesia were randomized into the MC and the King Vision VL groups in a 1:1 ratio. ETI was performed using either the MC (the MC group) or the King Vision VL (the VL group) with a COVID-19 barrier box. The first-pass intubation success rate, intubation time, and ease of ETI were analyzed. RESULTS: The first-pass success rate was higher in the MC group (P = 0.43). The mean duration of ETI was 33 s and 47 s in the MC group and VL group, respectively. The difference was statistically significant between the groups (P = 0.002). The ease of ETI was comparable between the groups (P = 0.57), and the Cormack–Lehane grade was significantly different between the groups (P = 0.0025). CONCLUSION: ETI duration was shorter in the MC group than in the VL group. Hence, a MC can be used along with a COVID-19 barrier box by experienced operators for the prevention of aerosol spread.