Awake intubation with C-MAC videolaryngoscope in a patient with difficult airway

Vaishnavi, BD; Syal, Rashmi; Vyas, Rakesh Kumar; Bihani, Pooja

doi:10.4103/ija.ija_631_20

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…Furthermore, recent propensity scores matched analysis focusing on trauma patients revealed that VL had twice the odds of first-pass success compared to DL (Trent et al, 2021) [ 35 ]. Many studies, although not specific to the emergency intubations, support the use of VL as the initial approach for patients with difficult airways [ 36 – 39 ]. These findings collectively suggest that VL may enhance first-attempt intubation success and improve visualization, particularly in challenging airways or emergencies where repeated attempts could pose risks or cause delays in airway management.…”

Section: Discussionmentioning

confidence: 99%

Video laryngoscopy versus direct laryngoscopy in achieving successful emergency endotracheal intubations: a systematic review and meta-analysis of randomized controlled trials

Alsabri,

Abdelwahab,

Elsnhory

et al. 2024

Syst Rev

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Background Intubating a patient in an emergent setting presents significant challenges compared to planned intubation in an operating room. This study aims to compare video laryngoscopy versus direct laryngoscopy in achieving successful endotracheal intubation on the first attempt in emergency intubations, irrespective of the clinical setting. Methods We systematically searched PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials from inception until 27 February 2023. We included only randomized controlled trials that included patients who had undergone emergent endotracheal intubation for any indication, regardless of the clinical setting. We used the Cochrane risk-of-bias assessment tool 2 (ROB2) to assess the included studies. We used the mean difference (MD) and risk ratio (RR), with the corresponding 95% confidence interval (CI), to pool the continuous and dichotomous variables, respectively. Results Fourteen studies were included with a total of 2470 patients. The overall analysis favored video laryngoscopy over direct laryngoscopy in first-attempt success rate (RR = 1.09, 95% CI [1.02, 1.18], P = 0.02), first-attempt intubation time (MD = − 6.92, 95% CI [− 12.86, − 0.99], P = 0.02), intubation difficulty score (MD = − 0.62, 95% CI [− 0.86, − 0.37], P < 0.001), peri-intubation percentage of glottis opening (MD = 24.91, 95% CI [11.18, 38.64], P < 0.001), upper airway injuries (RR = 0.15, 95% CI [0.04, 0.56], P = 0.005), and esophageal intubation (RR = 0.37, 95% CI [0.15, 0.94], P = 0.04). However, no difference between the two groups was found regarding the overall intubation success rate (P > 0.05). Conclusion In emergency intubations, video laryngoscopy is preferred to direct laryngoscopy in achieving successful intubation on the first attempt and was associated with a lower incidence of complications.

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Section: Discussionmentioning

confidence: 99%

Video laryngoscopy versus direct laryngoscopy in achieving successful emergency endotracheal intubations: a systematic review and meta-analysis of randomized controlled trials

Alsabri,

Abdelwahab,

Elsnhory

et al. 2024

Syst Rev

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“…The laryngoscopic view is magnified for the operator and there is extra space for tube manipulation. [ 11 12 13 ] Nevertheless, the use of VL requires skill and practice. Inexperienced operators may face difficulty while performing NTI with VL leading to prolonged intubation time.…”

Section: Discussionmentioning

confidence: 99%

A comparison of intubating conditions for nasotracheal intubation with standard direct Macintosh laryngoscope versus C-MAC® video laryngoscope employing cuff inflation technique in adult patients

Singh¹,

Kasaudhan²,

Gupta³

et al. 2021

Indian Journal of Anaesthesia

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Background and Aims: While performing laryngoscopy during nasotracheal intubation (NTI), the tip of the advancing endotracheal tube (ETT) generally lies along the posterior pharyngeal wall. The inflation of the ETT cuff brings it anterior towards the glottis. The present study was planned to compare the intubating conditions for NTI with standard direct Macintosh laryngoscope versus C-MAC ® video laryngoscope (VL) employing ETT cuff inflation technique. Methods: This prospective randomised study was carried out on 50 patients, American Society of Anesthesiologists physical status I–II, age 18–60 years of either sex with an indication for NTI under general anaesthesia. They were randomly divided into two groups: group VL ( n = 25): C-MAC ® VL and group ML ( n = 25): Macintosh laryngoscope. The primary outcome was to compare the total duration of NTI (T), while the secondary outcomes were to compare the need for cuff inflation or assistance with Magill forceps for successful NTI, the total number of attempts to achieve successful NTI, haemodynamic effects and complications. Results: T was significantly higher in group ML than group VL ( P < 0.001). The intubation was successful with cuff inflation in all the patients in group VL, however, six patients of group ML required assistance with Magill forceps ( P = 0.022). The haemodynamic parameters were all significantly higher at 3 min in group ML in comparison to group VL. Conclusion: The cuff inflation technique when used along with C-MAC ® VL had more success rate, required lesser time and had minimal postoperative complications in comparison to the Macintosh laryngoscope.

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“…These features make it an attractive option in difficult intubations, provided the mouth opening is more than 18 mm. [ 5 6 ] However, the use of D-blade in laryngeal tumours is not well documented with only few cases reported in the literature. [ 4 ] This study was conducted to evaluate the use of C-MAC VL D-blade (adult size) for awake orotracheal intubation in patients with laryngeal tumours undergoing elective surgery under GA.…”

Section: Introductionmentioning

confidence: 99%

Awake videolaryngoscopic orotracheal intubation in patients with laryngeal tumour using the C-MAC D-Blade

Jindal¹,

Selvam²,

Anand³

et al. 2022

Indian Journal of Anaesthesia

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Background and Aims: This study assessed the applicability of C-MAC videolaryngoscope (VL) D-blade for awake intubation in patients with laryngeal tumour. The primary study objective was to determine the rate of successful intubation in the first attempt. The other parameters recorded were number of attempts required for intubation, duration of different stages of intubation, haemodynamics, ease of intubation and patient comfort on visual analogue scale (VAS) postoperatively. Methods: Thirty patients were studied. Patients were sedated with dexmedetomidine and fentanyl as a slow bolus (over 20 min) and Ramsay sedation score was assessed. Topicalisation of the oropharynx, tonsillar pillars and base of the tongue was done with lignocaine 10% spray. Four ml of 4% lignocaine using MADgic atomiser was used for anaesthetising the glottis and the tracheal lumen. Results: Successful intubation was achieved in 86.6% patients in first attempt and 13.3% in two attempts. Total time for all intubations was less than 30 seconds. Fremantle score was F-1-C-MAC D-blade (easy intubation with full view) in 60% patients, while 23.3% had F-2-C-MAC D-blade (full view and either required more than one attempt or a modified technique), 13.3% had P-1-C-MAC D-blade (partial view with easy intubation) and 3.3% had P-2-C-MAC D-blade (partial view and required more than one attempt or a modified technique). The VAS score for anaesthesiologist’s ease and for patient’s experience was 85.83 ± 7.20 and 86.66 ± 14.46, respectively. Conclusion: C-MAC VL D-blade-assisted awake intubation is an effective and safe method to manage the airway of patients with laryngeal tumour once adequate topicalisation is ensured before the procedure.

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Awake intubation with C-MAC videolaryngoscope in a patient with difficult airway

Cited by 4 publications

References 5 publications

Video laryngoscopy versus direct laryngoscopy in achieving successful emergency endotracheal intubations: a systematic review and meta-analysis of randomized controlled trials

Video laryngoscopy versus direct laryngoscopy in achieving successful emergency endotracheal intubations: a systematic review and meta-analysis of randomized controlled trials

A comparison of intubating conditions for nasotracheal intubation with standard direct Macintosh laryngoscope versus C-MAC® video laryngoscope employing cuff inflation technique in adult patients

Awake videolaryngoscopic orotracheal intubation in patients with laryngeal tumour using the C-MAC D-Blade

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