Videolaryngoscopy in Airway Management: What Every Anesthesiologist Should Know!

Fu-Shan Xue , Ya-Yang Liu , Hui-Xian Li , Gui-Zhen Yang
Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Anesth Perioper Med 2018; 5(1): 23- 33 . Published on Jun 13, 2017 . doi:10.24015/JAPM.2017.0048
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Aim of review: The aim of this article is to convey several hotspot issues regarding the use of videolaryngoscopy (VL) in airway management that anesthesiologists are often concerned.
Methods: Recent literature in the past 20 years about the use of VL in the clinical airway management were searched from the Pubmed and Cochrane databases and reviewed, in order to determine the strengths and weakness of VL and conflicting issues regarding the role of VL in airway management.
Recent findings: The benefits of VL are most significant in patients with difficult airways, with an improved laryngeal view and an increased success rate of intubation. However, VL cannot give a 100% success rate and there is no specific evaluation system of difficult or failed VL as with direct laryngoscopy. Awake VL-assisted intubation is a useful alternative to awake fiberoptic intubation, but the fiberoptic bronchoscope cannot be discarded and still is gold standard tool of difficult airway management. There are several different-type VLs available and their efficacies may be different between devices due to various designs and shapes. Due to the limited number of comparative studies, however, there is inconclusive evidence to recommend which VL design is more advantageous in various clinical situations. A Macintosh-type VL allows residents to learn laryngoscopy and intubation more quickly and effectively. Given that VL has tremendous advantages, it should be used as the first-line device for all tracheal intubations.
Summary: The introduction of VL has resulted in a dramatic transformation of clinical airway management and is seen as the evolutionary step in intubation technology. There are considerable disagreements over the role of VL in airway management and the need of more investigation, but VL continues to get popularity both inside and outside the operating room. With increasing use of VL in airway management, experience and skill will undoubtedly increase, and the evidence will suggest that the attempt numbers and complications of intubations may be decreased, and patient safety can be improved. (Funded by the Major Project of Zhejiang Science and Technology Fund.)
Citation:  Fu-Shan Xue, Ya-Yang Liu, Hui-Xian Li, Gui-Zhen Yang. Videolaryngoscopy in Airway Management: What Every Anesthesiologist Should Know! J Anesth Perioper Med 2018;5:23-33.
doi: 10.24015/JAPM.2017.0048
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