Abstract
Purpose
This study was carried out to evaluate the relative efficacy of the C-MAC videolaryngoscope as compared to the conventional Macintosh laryngoscope using both styletted and non-styletted endotracheal tube (ETT) in patients undergoing elective cervical spine surgery with head and neck stabilized by manual in-line stabilization.
Methods
We randomized 120 consenting adults into four groups (30 each) to undergo tracheal intubation using either the Macintosh laryngoscope or C-MAC videolaryngoscope with styletted and non-styletted ETT.
Results
There was no significant difference between the C-MAC videolaryngoscope and Macintosh laryngoscope in Intubation Difficulty Scale (IDS) score using either styletted [median (IQR) 2 (1, 3) vs. 3 (2, 4); p = 0.58] or non-styletted ETT [median (IQR) 4 (2, 6) vs. 3 (2, 8); p = 1.00]. Similarly, when using a similar ETT-stylet assembly, the duration of successful intubation attempt, first attempt success rate, complications, use of airway optimization maneuvers, and adjuncts to facilitate intubation were comparable. The Cormack–Lehane view of the glottis was better with the C-MAC videolaryngoscope (p < 0.001). The use of stylet significantly reduced the IDS score [median (IQR) 2 (1, 3) vs. 4 (2, 6); p = 0.02], intubation time [median (IQR) 27 s (23, 31) vs. 52 s (28, 76); p < 0.001], and use of gum elastic bougie (3.3 % vs. 43.3 %, p < 0.001) with the C-MAC videolaryngoscope whereas no such effect was observed with the Macintosh laryngoscope.
Conclusions
Use of the C-MAC videolaryngoscope and Macintosh laryngoscope resulted in similar levels of intubation difficulty during cervical immobilization when used with a similar ETT-stylet assembly. The inclusion of the stylet significantly reduced the intubation difficulty experienced with the C-MAC videolaryngoscope.
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Gupta, N., Rath, G.P. & Prabhakar, H. Clinical evaluation of C-MAC videolaryngoscope with or without use of stylet for endotracheal intubation in patients with cervical spine immobilization. J Anesth 27, 663–670 (2013). https://doi.org/10.1007/s00540-013-1588-6
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DOI: https://doi.org/10.1007/s00540-013-1588-6