Comparison of Outcomes of Endotracheal Intubation Using Video Versus Macintosh Laryngoscope in Patients Undergoing Coronary Artery Bypass Grafting: A Randomized Controlled Trial

Abstract

Objectives: Aim of this study was to compare the outcomes of Endotracheal intubation (ETI) using video laryngoscopy versus Macintosh laryngoscopy in patients undergoing elective CABG. Methodology: This prospective randomized controlled trial enrolled 156 patients scheduled for elective CABG from March to September 2022. Participants were randomly assigned to undergo ETI with either a video laryngoscope (Group V, n=78) or a Macintosh laryngoscope (Group M, n=78). The primary outcomes were first-attempt intubation success rate and total intubation time. Standardized anesthesia protocols were applied to both groups. Results: Baseline characteristics, including age, gender, BMI, and smoking status, were comparable between groups. First-attempt intubation success was higher in Group V (62.8%) compared to Group M (52.6%), although not statistically significant (p=0.19). However, mean intubation time was significantly shorter in Group M (32.8 ± 7.89 seconds) compared to Group V (35.7 ± 4.88 seconds; p=0.001). Subgroup analyses demonstrated consistent trends of higher success with video laryngoscopy, particularly in obese and smoking patients, though without statistical significance. Conclusion: Video laryngoscopy provided higher first-attempt intubation success, whereas Macintosh laryngoscopy demonstrated faster intubation times. Both devices were safe and effective, suggesting that VL may be advantageous in specific high-risk subgroups, while ML may remain superior for procedural speed.