Success rates of video vs. direct laryngoscopy for endotracheal intubation in anesthesiology residents: a study protocol for a randomized controlled trial (JuniorDoc-VL-Trial)

Trials. 2025 Feb 27;26(1):75. doi: 10.1186/s13063-025-08785-y.

Abstract

Background: Tracheal intubation is a core skill in airway management for anesthesiologists as well as for other medical professionals involved in advanced airway procedures. Traditionally, tracheal intubation in hospitals has been performed using a Macintosh blade for direct laryngoscopy (DL). However, recent literature increasingly supports the potential benefits of routine video laryngoscopy (VL). The aim of this study was to assess whether primary training in hyperangulated VL improves the first-pass success rate of tracheal intubation among first-year anesthesiology residents, compared to conventional DL training, in the operating room.

Methods: The JuniorDoc-VL Trial is a randomized, controlled, patient-blinded clinical trial of novice anesthesiology residents trained in DL and VL. Thirty residents will be randomly assigned to either the intervention group (VL group) or the control group (DL group) with a 1:1 allocation. The first-pass-success (FPS) rates (primary endpoint) and complication rates (secondary endpoint) will be compared between groups.

Discussion: We hypothesize that the primary use of hyperangulated video laryngoscopy (VL) in the experimental group will increase first-pass-success rates among inexperienced residents and reduce complication rates associated with advanced airway management in a mixed patient population. This study may provide an opportunity to develop strategies that allow physicians not routinely involved in anesthesia to effectively learn and maintain their skills in tracheal intubation.

Trial registration: ClinicalTrials.gov Registry (NCT06360328). Registered on 09.04.2024.

Keywords: Direct laryngoscopy; First-pass-success; Learning success; Skill of intubation; Tracheal intubation; Video laryngoscopy.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Anesthesiology* / education
  • Clinical Competence
  • Humans
  • Internship and Residency*
  • Intubation, Intratracheal* / adverse effects
  • Intubation, Intratracheal* / methods
  • Laryngoscopy* / adverse effects
  • Laryngoscopy* / education
  • Laryngoscopy* / methods
  • Randomized Controlled Trials as Topic
  • Video Recording
  • Video-Assisted Techniques and Procedures*

Associated data

  • ClinicalTrials.gov/NCT06360328