Comparative analysis of a 3D-printed videolaryngoscope versus the Macintosh model in adult airway management: a randomized clinical trial.

BACKGROUND AND

OBJECTIVES

Video Laryngoscopy (VL) provides enhanced glottic visualization in airway management, but its high cost limits adoption. Three-Dimensional (3D) printing offers a cost-effective alternative for producing VL devices. This randomized trial compared a 3D-printed Videolaryngoscope (VL3D) with the standard Macintosh Laryngoscope (MAC) during tracheal intubation in adults.

METHODS

This was a randomized, controlled, and assessor-blinded clinical trial. The primary outcome was intubation difficulty, assessed using the Intubation Difficulty Scale (IDS). Secondary outcomes included glottic visualization (Cormack-Lehane grade) and Intubation Time (IT). The final analysis followed a modified intention-to-treat principle.

RESULTS

This study included 52 patients scheduled to undergo general anesthesia with tracheal intubation. Baseline characteristics were comparable between groups. The analysis included 49 patients (VL3D, n = 26; MAC, n = 23). Categorical analysis of the primary outcome showed a higher incidence of moderate-to-severe intubation difficulty in the VL3D group (23.1% vs. 0%, p = 0.032), although median IDS scores were statistically similar. In relation to secondary outcomes, the VL3D provided significantly superior glottic visualization (Cormack-Lehane grade I: 72.0% in the VL3D group vs. 33.3% in the MAC group, p = 0.002). Conversely, the VL3D was associated with a significantly longer intubation time (median 70 seconds vs. 40 seconds, p = 0.005).

CONCLUSIONS

The VL3D demonstrated superior glottic visualization but correlated with significantly longer intubation duration and greater procedural difficulty. These findings suggest that additional specialized training or design optimization is necessary before widespread clinical implementation.