Universal videolaryngoscopy and intubation outcomes in anaesthesia trainees: A subanalysis of the multicentre VIDEOLAR-SURGERY trial

Tracheal intubation is a core procedural skill in anaesthesia training. Videolaryngoscopy provides improved glottic visualisation and shared airway views, but its effect on trainee-performed intubations in routine clinical practice remains uncertain. This subanalysis of a prospective, multicentre, non-randomised before-and-after study evaluated whether adopting videolaryngoscopy as the universal first-intention device improved intubation performance among anaesthesia trainees. Eight hospitals in Northwest Spain contributed 1801 trainee-performed intubations (857 before and 944 after intervention). During the non-intervention phase, direct laryngoscopy with a Macintosh blade was used, whereas the McGrath MAC videolaryngoscope was systematically adopted during the intervention phase. The primary outcome was easy intubation, defined as first-attempt success, Cormack–Lehane grade I–IIa view and no adjunct use. Easy intubation occurred more frequently with videolaryngoscopy (83.1% vs 69.3%; p < 0.001). First-attempt success (87.9% vs 77.0%; p < 0.001) and favourable glottic visualisation (91.5% vs 84.9%; p < 0.001) were also higher. Adjunct use, operator change and complications were reduced. Improvements were consistent across both junior and senior trainee groups. Universal videolaryngoscopy was associated with improved overall intubation performance among anaesthesia trainees in routine operating room practice. These findings suggest that videolaryngoscopy may be a valuable tool to support airway management training and improve intubation conditions in clinical practice.