Comparison of Cormack Lehane Grading System and Intubation Difficulty Score in Patients Intubated by D-Blade Video and Direct Macintosh Laryngoscope: A Randomized Controlled Study

Abstract

SUMMARY -D-blade is a relatively new device in the fi eld of videolaryngoscopy, designed for airway management by enabling indirectoscopic glottic view. In our study, we investigated effi ciency of D-blade in comparison with direct Macintosh laryngoscope (gold standard). Fifty-two adult patients with normal airway scheduled for elective surgery in general anesthesia were randomly assigned in D-blade video or direct Macintosh group. In the fi rst video group, patients were laryngoscoped and intubated by D-blade, and in the second group laryngoscopy and intubation were performed by Macintosh laryngoscope. Glottic view was evaluated according to Cormack Lehane grading system (C-L), while duration of intubation and easiness of intubation were evaluated according to the intubation diffi culty score (IDS). Additionally, hemodynamic parameters were recorded before and after induction. Th ere were no statistically signifi cant between-group diff erences in time to intubation, easiness of endotracheal tube insertion, C-L, and IDS. In comparison with direct Macintosh laryngoscope, D-blade showed similar but still favorable characteristics. In our opinion, D-blade is a useful device in airway management and should be used in daily anesthesiologist work.

Comparisons of Videolaryngoscopes for Intubation Undergoing General Anesthesia: Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

“…The characteristics of the included studies are shown in Table 1 [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 ,…”

“…In the rank analysis using SUCRA, CMD was the overall most successful VL (SUCRA 77.7) and in the context of difficult airway (SUCRA 85.2) status. The pooled success rates of CMD were 90.6% (358/395 patients) in the all airway status category (the range of success rate = 81–100% in eight included studies) [ 13 , 29 , 61 , 78 , 89 , 92 , 93 , 103 ] and 92.7% (178/192 patients) in the difficult airway status category (the range of success rate = 92–95% in three included studies) [ 29 , 61 , 89 ]. In the normal airway status category, King Vision was the most successful (SUCRA 72.7), and the pooled success rate of King Vision was 92% (169/183 patients; the range of success rate = 68–100% in five included studies) [ 30 , 47 , 48 , 78 , 88 ] ( Figure 3 , Figure 4 and Figure 5 ).…”

“…Channeled VLs include Airtraq, Airwayscope and King Vision, whereas non-channeled VLs include GlideScope, C-MAC, C-MAC D-blade (CMD), and McGrath. Although it appears that the mechanism of VL is helpful in increasing success rates, several randomized controlled trials (RCTs) have suggested that VLs are surprisingly not more effective than MCL [ 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. However, the results of all existing meta-analyses are still conflicting and are limited to the comparison of specific VL and MCL [ 15 , 16 , 17 , 18 , 19 ].…”