OBJECTIVE: To evaluate the stress response during general anesthesia intubation using the Safe Easy Endotracheal Kit-flexible (SEEKflex) with a video laryngoscope. METHODS: From January to May 2023, 95 patients scheduled for elective surgery under general anesthesia were randomly assigned to either the traditional tube core group (n = 48) or the SEEKflex-guided group (n = 47). Vital signs and the first intubation success rate were recorded from pre-intubation to 2 minutes post-intubation. The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2200066808). RESULTS: The incidence of elevated blood pressure was significantly lower in the SEEKflex-guided group compared to the traditional tube core group (27.66% vs. 56.25%, P<
0.05). Although the overall intubation success rate was 100% in both groups, the first intubation success rate was significantly higher in the SEEKflex-guided group (100% vs. 91.67%, P<
0.05). CONCLUSION: SEEKflex-guided intubation, compared to the traditional tube core method, resulted in more stable hemodynamic responses and a higher first intubation success rate.