• David Macnair, Dan Baraclough, Graham Wilson, Mark Bloch, and Thomas Engelhardt.
• Department of Paediatric Anaesthesia, Royal Aberdeen Children's Hospital, Aberdeen, UK.
• Paediatr Anaesth. 2009 Jun 1;19(6):577-80.

ObjectivesTo assess the utility of the Berci-Kaplan Video Laryngoscope (VL) in pediatric anesthesia.BackgroundThe VL is designed to improve visualization of the glottis during tracheal intubation of normal and difficult airways in adults. This study was designed to assess the visual quality and the ease of tracheal intubation in children using the VL when compared with direct laryngoscopy (DL).MethodsSixty children, aged 2-16 years requiring tracheal intubation, were enrolled in this prospective, randomized clinical trial. Following induction of anesthesia and muscle paralysis, the first laryngoscopy method, using either a DL or the VL, was performed by one anesthetist, and the laryngoscopic view was graded according to the Cormack-Lehane scale. Laryngoscopy and grading of the view in the second method were then performed by a second anesthetist. Tracheal intubation was completed following the second laryngoscopy, and time to intubation was recorded.ResultsThe average age and weight were 8.9 +/- 3.6 years and 34.9 +/- 16.0 kg respectively. Videolaryngoscopy improved 8/11 grade 2 views to grade 1 (P = 0.02), and one grade 3 to a grade 2. Three grade 2 views remained unchanged from DL to VL. 4/30 VL intubations required two attempts, and 1/30 failed after two attempts, but was easily intubated with DL. Median time (range) was 16.0 s (14.0-20.0 s) and 22.5 s (17.8-35.0 s) for DL and VL respectively (P < 0.001).ConclusionVideolaryngoscopy provides better views than DL at the expense of time to intubate. Although the time taken to intubate is increased with the VL, it is clinically acceptable.

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