Direct Laryngoscopy or Video Laryngoscopy: Which is Better for Performing Endotracheal Intubation?

Endotracheal intubation is known as the best and challenging procedure to airway control for patients in shock or with unprotected airways. Failed intubation can have serious consequences and lead to high morbidity and mortality of the patients. So, many clinical criteria have been introduced with regard to evaluation of the patient’s airway before induction of anesthesia. One of them is, the Cormack-Lehane Grading (CLG) which assists in predicting difficult intubation performed under direct laryngoscopy. Failure to view any portion of the glottis is classified CLG 4 and is considered as a difficult airway. The Gold Standard (Traditional) Laryngoscope (Macintosh) and Video laryngoscopes are the subject of research in this review. Data collection obtained from Currently available evidence, PubMed, Google scholar, Cochrane Evidence Based Medicine, of new anesthesia books, published conferences and cited articles from journals, were matched with the base forms of reviews related to laryngoscopy and tracheal intubation within the interval of 2013 to 2021.  The comparative studies of different video laryngoscopes showed that DL compared with VL, reveal that video laryngoscopes reduced failed intubation in anticipated difficult airways. The main goal of this review is to compare the direct laryngoscopy with the (indirect) video laryngoscopy in terms of increased first success rate and  good vision of the larynx to find a smooth induction of endotracheal intubation in the hands of  both the experienced and novice in different health settings.

Author(s): Haithem M. Almamoori 

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