Clinical experience with the C-Mac videolaryngoscope in morbidly obese patients

Abstract

Background: The use of videolaryngoscopes is recommended as a part of routine practice in anaesthesia for morbidly obese patients. The aim of this study was to evaluate C-Mac in a group of morbidly obese patients to see if it improves intubation conditions. Methods: 86 morbidly obese (BMI > 40 kg m -2 ) patients scheduled for bariatric surgery were included in the study. In every studied case, C-Mac was used with a Mackintosh shaped blade. For the first attempt, the anaesthetists performing the intubation were asked to use a videolaryngoscope as a standard laryngoscope (they were blinded to the monitor display) and evaluate the glottic view in direct laryngoscopy. Then they were asked to look at the monitor of the videolaryngoscope and intubate the patient. The laryngoscopy conditions were evaluated using the Cormack--Lahane (CL) scale. The time from picking up the laryngoscope to inserting the endotracheal tube was recorded. Results: The evaluation of CL grade in direct laryngoscopy was: 44 patients -grade 1; 23 patients -grade 2; 13 patients -grade 3; six patients -grade 4. In all cases of CL grade > 1 in direct laryngoscopy, the use of C-Mac improved CL grade to 1. Mean time of intubation was 17.2 ± 2.5 sec. Conclusion: The C-Mac improves laryngeal view in morbidly obese patients, and allows for fast endotracheal intubation.

Comparison of the C-MAC®and GlideScope®videolaryngoscopes in patients with cervical spine disorders and immobilisation

“…After this initial laryngoscopy, the trachea was intubated with either the C-MAC or the GlideScope and the modified C-L grading was documented. The C-MAC was used as indirect laryngoscope throughout the protocol (as opposed to a direct laryngoscope [14]). When the GlideScope was used, a rigid stylet was inserted in the tracheal tube.…”

Muscle activity during endotracheal intubation using 4 laryngoscopes (Macintosh laryngoscope, Intubrite, TruView Evo2 and King Vision) – A comparative study

“…In modern anesthesiology, the main cause of serious complications, including hypoxic brain injury is connected to difficulties with airway management and oxygenation [19]. Especially in selected groups of patients like morbidly obese, because of body composition and airway anatomy, forces necessary to visualize entrance to larynx using standard laryngoscopes are significantly higher, thus the workload during intubation attempts is increased [20]. New ergonomic devices for airway management may improve situation.…”

A Comparison of Performance of Endotracheal Intubation Using the Levitan FPS Optical Stylet or Lary-Flex Videolaryngoscope in Morbidly Obese Patients

“…but more intubation efforts (average 1.4) [17]. We evaluated the C-MAC videolaryngoscope (Storz, Germany) in morbidly obese patients and we found that it improved the laryngeal view [9]. In this study and the presented study, all cases of the intubation were successful within the recommended time for intubation attempts, which is especially important in morbidly obese patients, in whom desaturation is faster than that in nonobese patients [18].…”

“…The use of videolaryngoscopes should improve laryngeal view in morbidly obese patients [8, 9]. Although obesity alone is not a risk factor for difficult intubation [10], it is recommended to use videolaryngoscopes as a part of routine practice in anesthesia for morbidly obese patients [11].…”