Comparison of Macintosh laryngoscope and C-MAC video laryngoscope for intubation in lateral position

Abstract

Background and Aims:Endotracheal intubation is conventionally performed when the patient is in supine position. It may be required to secure airway in laterally positioned patient. Tracheal intubation in lateral position seems to be difficult because the laryngeal view is compromised. Hence, C-MAC video laryngoscope (Karl Storz, Germany), a newer device using a modified macintosh blade may be useful for intubation in lateral position.Material and Methods:A total of 100 American Society of Anesthesiologists Grade I and II patients, randomly allotted to C-MAC or direct laryngoscopy group. Patients with difficult airway were excluded. After induction of anesthesia, patient was put in right-lateral position and intubation was carried out by consultant who is well-versed in using C-MAC laryngoscope. Time for intubation, number of attempts, Modified Cormack – Lehane grade, mucosal injury, and external laryngeal manipulation applied were noted.Statistical Analysis:Demographics and baseline airway assessments were analyzed using summary statistics. Unpaired t-test was used to assess intubation time. Number of attempts, esophageal intubation, dental injury, mucosal injury, use of stylet, and application of external laryngeal manipulation were analyzed using Chi-square test.Results:Overall intubation success rate was 100%. The time taken in C-MAC group was 24.8 ± 8.5 s and in direct group was 33.8 ± 9.12 s. The number of intubation attempts was not significant. Cormack – Lehane grade was better with C-MAC laryngoscope. Mucosal injury and use of external laryngeal manipulation was more in direct group.Conclusion:C-MAC is better than Macintosh laryngoscope for intubation in lateral position.

Randomized controlled study comparing the hemodynamic response to laryngoscopy and endotracheal intubation with McCoy, Macintosh, and C-MAC laryngoscopes in adult patients

“…Hence, we compared the hemodynamic response to oral endotracheal intubation using McCoy and C-MAC laryngoscopy with that of conventional Macintosh laryngoscopy in adult patients posted for elective surgery under general anesthesia. One recent study[6] has shown that C-MAC ® videolaryngoscopy needed less duration of laryngoscopy for successful intubation compared to Macintosh laryngoscopy even in lateral position. Duration of laryngoscopy is an expected variable to affect the degree of hemodynamic response to endotracheal intubation.…”

GlideScope® cobalt video laryngoscope versus direct Miller laryngoscope for lateral position-tracheal intubation in neonates with myelodysplasia: A prospective randomized study

“…So, time to best laryngeal view and intubation attempts may be increased with DL compared with video laryngoscope, which offers a magnified, brighter image with a quick insertion in the pharyngeal midline without displacing the tongue. [ 11 19 20 ]…”

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

“…Th e simplicity of glottic visualization is not always followed by easy tube insertion and longer intubation time may be required [1][2][3]8,19 . In the study by Bhat et al 20 , signifi cantly shorter intubation time was recorded in video group, although intubation was performed in diffi cult lateral position. Unlike these results, our study showed nonsignifi cant diff erence in intubation time, and there were no diffi culties in tube insertion despite using different stylets in study groups.…”