Comparison of Intubation Characteristics between Non-channeled King Vision Video Laryngoscope and I-scope in Simulated Cases of Restricted Mouth Opening Ioin Manikin. A Pilot Study

Background and Aims: Restricted mouth opening limits all the options of conventional laryngoscopy and endotracheal intubation. Comparison of intubation characteristics between non-channeled King Vision laryngoscope and I-scope was done in simulated restricted oral opening scenario using manikin. Materials and Methods: Total 120 intubations were done by thirty participating anesthesiologists in manikin, with restricting mouth opening to 2 cm with the help of limiting sutures taken at angle of mouth to simulate difficult airway. Time of laryngoscopy until best glottic view was recorded. POGO score (percentage of glottic opening) was assessed; ease of intubation and incidence of successful intubation were also recorded with each laryngoscope separately in both the neutral and sniffing positions. Results: There was 100% success rate for intubation in both the groups. However, first attempt success rate was significantly higher in I-scope group compared to King Vision group (96.6% vs. 83.3%, P = 0.033). The median time for best glottic view was comparable in both the groups (4.9 vs. 5.2 seconds; P = 0.157), however overall duration for intubation was significantly lesser with I-scope when compared to King Vision (8.2 vs.14.5 seconds; P < 0.001). Ease of intubation and success of intubation in neutral position were also significantly better in I-scope group. POGO score was similar in both the groups. Conclusion: I-scope is helpful in securing the airway quickly and easily without much learning curve and expertise as compared to king Vision video laryngoscope in cases with limited mouth opening.