Conventional vs. Video-Assisted Laryngoscopy for Perioperative Endotracheal Intubation

Conventional vs. Video-Assisted Laryngoscopy for Perioperative Endotracheal Intubation

COVALENT is a randomized, controlled, multi-center study that aims to evaluate the clinical routine practice of endotracheal intubation in an operative setting comparing video-assisted laryngoscopy to direct laryngoscopy.

Data on the routine use of video-assisted laryngoscopy in peri-operative intubations are rather inconsistent and ambiguous, in part due to small study populations and non-uniform outcome measures in past trials. Failed or prolonged intubation procedures are a reason for relevant morbidity and mortality. This study aims to determine whether video-assisted laryngoscopy (irrespective of the shape of the blade) is non-inferior to the standard method of direct laryngoscopy with respect to the first-pass success rate. Furthermore, validated tools from the field of human factors will be applied to examine within-team communication and task load during this critical medical procedure.

Inclusion Criteria:

• Adult, legally competent patients
• Scheduled for elective, non-cardiac surgical procedure
• Need for endotracheal intubation as determined during the premedication visit
• Informed consent
• Care providers performing the intubation have at least one year of training in anesthesiology and experience in the use of VAL

Exclusion Criteria:

• Lack of ability to give consent
• Previous participation in this study
• Pregnancy
• Need for fiberoptic intubation
• Patients scheduled for bariatric surgery
• Any circumstance that will lead the anesthesiologist(s) in charge to believe that random assignment of a laryngoscopy instrument may compromise patient safety during induction of anesthesia