Comparison of conventional versus channeled blade in tracheal intubation using video laryngoscope: a prospective randomized controlled trial

Background: During tracheal intubation using video laryngoscopy, manipulating the tracheal tube may be challenging because of misalignment between the camera’s visual axis and the curvature of the tube, which can hinder smooth tube advancement and potentially increase the risk of airway trauma. A channeled laryngoscope blade, which allows the tube to be preloaded and guided directly along the visual axis, may facilitate easier intubation and reduce soft tissue injury, thereby offering a potential advantage over conventional blades. This study compared the performance of channeled and conventional blades for tracheal intubation using video laryngoscopy. Methods: In this prospective randomized controlled trial, 140 adult patients undergoing elective spine surgery were randomly assigned to intubation with either a conventional blade (Group Co) or a channeled blade (Group Ch). The primary outcome was the intubation time, measured from the insertion of the laryngoscope to confirmation of successful tracheal intubation. Secondary outcomes included the initial intubation success rate and intubation-related complications, such as bleeding, sore throat, and hoarseness. Results: Baseline characteristics were comparable between the two groups. The median intubation time was longer in Group Ch (20.7 s) than in Group Co (19.5 s, p = 0.008). However, the initial success rate and the incidence of intubation-related complications were similar between the two groups. Conclusions: The channeled blade was associated with a slightly longer intubation time but demonstrated a similar success rate and safety profile compared to the conventional blade. Both blade types showed comparable clinical performance, suggesting that the choice between them may be guided by operator preference. Clinical Trial Registration: NCT04948294, retrospectively registered.