A randomized controlled comparison of the B onfils fiberscope and the G lide S cope C obalt AVL video laryngoscope for visualization of the larynx and intubation of the trachea in infants and small children with normal airways

Summary Background The B onfils fiberscope ( BF ) used without the assistance of a laryngoscope failed to improve the view of direct laryngoscopy in children with normal airways. We hypothesized that if BF is supported by a laryngoscope—as recommended by its inventor—it can provide comparably good visualization of the glottis as the G lideScope ® C obalt AVL video laryngoscope ( GS ). Methods We included 100 children with normal airways in a randomized controlled trial. The study consisted of assessing the airway by direct laryngoscopy ( DL ), followed by intubation using either the BF or the G lide S cope. Main outcome measures were the quality of visualization of the larynx by the percentage of glottis opening seen ( POGO ) and the time needed for intubation of the trachea. Results Visualization of the larynx ( POGO ) using the BF was significantly better than with DL ( P = 0.016 ) or with GS ( P = 0.001 ). The DL provided an allover better visualization than GS , although this difference was not significant and solely attributable to children weighing <15 kg. Intubation was successful in all cases with both devices. The time needed for intubation was shorter using the BF (36 ± 8 s) than with the GlideScope (49 ± 12 s, P < 0.001 ). Conclusion The B onfils fiberscope significantly improved the view on the larynx compared with direct laryngoscopy and the GlideScope and enables shorter intubation time than with the G lide S cope.