RESEARCH REPORT Comparison of intubation conditions with CMAC Miller videolaryngoscope and conventional Miller laryngoscope in lateral position in infants: A prospective randomized trial Divya Jain 1 | Swati Mehta 1 | Komal Gandhi 1 | Suman Arora 1 | Badal Parikh 1 | Muneer Abas 2 1 Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India 2 Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India Correspondence Divya Jain, Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Email: jaindivya77@rediffmail.com Section Editor: Britta von Ungern-Sternberg Summary Background: Endotracheal intubation in lateral position in infants is a challenge. This difficulty may be surmounted to some extent by using videolaryngoscopes but the routine use of these devices as a tool to secure the airway in lateral position remains unevaluated. Therefore, we conducted a prospective, randomized controlled trial to compare the intubation conditions achieved with the CMAC videolaryngo- scope and the Miller Laryngoscope in lateral position in infants. We hypothesized that CMAC videolaryngoscope would provide a better laryngoscopic view and reduce the time to intubation compared to the Miller blade. Methods: Sixty-four children aged <1 year, belonging to American Society of Anes- thesiologists physical status I-III requiring endotracheal intubation were randomized to undergo tracheal intubation with either the Miller laryngoscope (n = 32) or the CMAC videolaryngoscope (n = 32) in left lateral position. Anesthesia was induced with sevoflurane or thiopentone 5-8 mg/kg IV and atracurium 0.5 mg/kg IV. Total time taken to intubate was assessed as the primary outcome. Laryngoscopic view, intuba- tion difficulty score, success rate of tracheal intubation, number of attempts, maneu- vers used, and any airway complications were recorded as secondary outcomes. Results: The difference in the mean time to intubate (95% confidence interval) between the Miller and CMAC group was 6.1 (1.7-10.4) seconds. Furthermore, the CMAC videolaryngoscope provided a better laryngoscopic view compared to the conventional Miller blade. In addition, the Intubation Difficulty Scale score was less in the CMAC videolaryngoscope group. Conclusion: The CMAC videolaryngoscope decreases the time taken to intubate and reduces the intubation difficulty when compared to the Miller laryngoscope. Therefore, the CMAC videolaryngoscope may be more useful device when intubat- ing the trachea of infants in the lateral position. KEYWORDS airway device, infants, lateral position The trial was registered with Clinical trial registry of India, CTRI/2016/10/007407. The recruitment commenced on 1 November 2016. Preliminary data for this study would be presented at the 9th National Conference on Pediatric Anesthesia, 17-19 February 2017, Lucknow, India. Accepted: 6 December 2017 DOI: 10.1111/pan.13316 Pediatric Anesthesia. 2018;1–5. wileyonlinelibrary.com/journal/pan © 2018 John Wiley & Sons Ltd | 1