Conventional vs Video-Assisted Laryngoscopy for Perioperative Endotracheal Intubations: A Randomized…

Randomized trialJAMA network open· Aug 2026

Conventional vs Video-Assisted Laryngoscopy for Perioperative Endotracheal Intubations: A Randomized Clinical Trial.

Benedikt Schmid, Linda Grüßer, Lukas Müller … German Society of Anaesthesiology and Intensive Care (GSAIC) Trials Group

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Airway ManagementRandomized trialClinical practiceQ1IF 8.1

Hyperangulated video laryngoscopy achieved the highest first-pass intubation success rate

Conventional vs Video-Assisted Laryngoscopy for Perioperative Endotracheal Intubations: A Randomized Clinical Trial.

Benedikt Schmid … German Society of Anaesthesiology and Intensive Care (GSAIC) Trials Group

JAMA network open · Aug 2026 · Q1 in General Medicine

Background

IMPORTANCE: Video laryngoscopy is increasingly used in routine tracheal intubation in the operating room, but evidence regarding its clinical outcomes remains inconclusive.

Purpose

To determine whether video laryngoscopy-regardless of blade geometry or manufacturer-provides superior first-pass success compared with direct laryngoscopy (direct laryngoscopy) during routine tracheal intubations.

Methods

Were sampled consecutively until trial staff capacity limits were met for any given day.

n = 2532 patients

Results

hyperangulated video laryngoscopy achieved the best first-attempt success

DL

78.2%

VLM

82.9%

VLH

87.6%

More results

Unadjusted absolute risk differences for first-pass intubation success were 4.66 (95% CI, 4.45-4.78) percentage points for direct laryngoscopy vs VLM, 9.34 (95% CI, 9.22-9.46) percentage points for direct laryngoscopy vs VLH, and 4.68 (95% CI, 4.57-4.79) percentage points for VLM vs VLH.

More results

VLM and VLH compared with direct laryngoscopy had faster intubation success after a failed first attempt (mean [SD] time to positive capnography, 146.6 [103.6] and 147.5 [98.9] seconds vs 170.3 [100.4] seconds; P = .008).

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Conclusion · 1 of 2

This randomized clinical trial of direct laryngoscopy vs VLM and VLH found that video laryngoscopy significantly improved first-pass success during intubation in the operating room compared with direct laryngoscopy.

Conclusion · 2 of 2

The findings support the use of video laryngoscopy as a new standard of care for routine airway management.

Conventional vs Video-Assisted Laryngoscopy for Perioperative Endotracheal Intubations: A Randomized Clinical Trial.

Conventional vs Video-Assisted Laryngoscopy for Perioperative Endotracheal Intubations: A Randomized Clinical Trial.

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