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Objectives: To test the hypothesis that laryngoscopy using the Airtraq (Prodol Limited, Viscaya, Spain) or King Vision laryngoscope (KVL) (Ambu A/S, Ballerup, Denmark) would result in a shorter time for successful double-lumen endobronchial tube (DLT) intubation by users with mixed experience than the time required using the Macintosh or GlideScope (Verathon Inc., Bothell, WA) laryngoscopes., Design: A randomized, prospective, blind study., Setting: A single university hospital., Participants: The study comprised 133 patients undergoing elective thoracic surgery., Interventions: Patients were randomly allocated into the following 4 groups of DLTs: Macintosh (n = 32), GlideScope (n = 34), Airtraq (n = 35), or KVL (n = 32)., Measurements and Main Results: The following data were recorded: time required for achieving successful DLT intubation; glottis visualization; optimization maneuvers; first-pass success rate; intubation difficulty; failure to intubate, defined as an attempt taking >150 seconds to perform or if peripheral oxygen saturation <92% was noted; and postoperative sore throat and hoarseness were recorded. Compared with GlideScope, the Airtraq resulted in shorter times for achieving successful DLT intubation (median times: 21 s [95% confidence interval 23.9-70.8 s] v 57.5 s [95% confidence interval 46.2-89.1 s], respectively; p = 0.021); a lower score for difficult intubations (p = 0.023); and fewer optimization maneuvers. The 4 laryngoscopes were associated with comparable glottis visualization; first-pass success rate (100%, 100%, 94.4%, and 100%, respectively; p = 0.522); incidence of oropharyngeal trauma; postoperative sore throat; and hoarseness of voice. There were 2 (5.7%) endobronchial intubation failures using the Airtraq due to the inability to advance the DLT through the glottis opening. The experience of the anesthesiologists in using the 4 devices had a statistically significant negative correlation with the time to confirmation of endobronchial intubation (Spearman r -0.392; p < 0.001)., Conclusion: When used by operators with mixed experience, the channeled Airtraq required less time for DLT intubation and was easier to use than the GlideScope, although failures did occur with the Airtraq, whereas they did not occur with the other systems., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: The King Vision™ (KVL) and Airtraq® videolaryngoscopes may reduce the time to double lumen tube (DLT) intubation compared to the GlideScope® and MacIntosh in simulated easy and difficult airways., Methods: Twenty-one staff anesthesiologists with limited prior experience in using videolaryngoscopes for DLT intubation were assigned randomly to insert a DLT using the MacIntosh, GlideScope®, Airtraq® and KVL videolaryngoscopes on easy and difficult airway simulators in a randomized crossover order. Time to DLT intubation, laryngoscopic view, intubation difficulty, optimizing manoeuvers and failure to intubation - defined as an attempt taking longer than 150 s - were recorded., Results: The three videolaryngoscopes had comparable times to intubation and glottis visualization in both scenarios. Compared with the MacIntosh, the KVL had longer intubation times in the simulated easy airway scenario (mean 9.2 vs. 21.1 s, respectively, P<0.001). In both scenarios, the Airtraq® took a longer intubation time than the MacIntosh (P<0.001 and P=0.019, respectively). The GlideScope® was easier to use than the Airtraq® and KVL in the easy airway scenario (P=0.021 and P=0.001, respectively). The KVL had higher intubation difficulty scores than the GlideScope® and Airtraq® (P=0.002 and P=0.008, respectively) in both scenarios and required more frequent optimizing manoeuvers than the GlideScope® (P=0.012) in the simulated easy airway. Two participants failed to intubate the difficult airway simulator; one with the MacIntosh and the other with the KVL., Conclusions: The Airtraq® and non-channeled KVL required more time over the MacIntosh for DLT intubation, as a primary outcome, but the success rates for the 3 videolaryngoscopes were very high.