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

Abstract

SummaryIn-line stabilisation of the neck can increase the difficulty of tracheal intubation with direct laryngoscopy. We randomly assigned 56 patients with cervical spine pathology scheduled for elective surgery to tracheal intubation using either the C-MAC â (n = 26) or GlideScope â (n = 30), when the head and neck were stabilised in-line. There was no significant difference in the median (IQR [range]) intubation times between the C-MAC (19 (14-35 [9-90]) s and the GlideScope (23, (15-32 [8-65]) s. The first-attempt failure rate for the C-MAC was 42% (95% CI 23-63%) compared with 7% (95% CI 1-22%) for the GlideScope, p = 0.002. The laryngeal view was excellent and comparable with both devices, with the C-MAC requiring significantly more attempts and optimising manoeuvers (11 vs 5, respectively, p = 0.04). There were no significant differences in postoperative complaints e.g. sore throat, hoarseness and dysphagia. Both devices provided an excellent glottic view in patients with cervical spine immobilisation, but tracheal intubation was more often successful on the first attempt with the GlideScope.

Use of the GlideScope Ranger Video Laryngoscope for Emergency Intubation in the Prehospital Setting: A Randomized Control Trial*

“…In this regard, video laryngoscopes were found to provide a great visualization of the glottis (10) and to improve endotracheal intubation success rates (24). The GlideScope video laryngoscope (Verathon) has been evaluated in manikin studies (19,20,25), the operating room (7,26,27), emergency departments (28), and ICUs (9,18). There is evidence that especially subjects at higher risk of a difficult airway benefit from GlideScope-assisted intubation (26,29,30).…”

“…The GlideScope video laryngoscope (Verathon) has been evaluated in manikin studies (19,20,25), the operating room (7,26,27), emergency departments (28), and ICUs (9,18). There is evidence that especially subjects at higher risk of a difficult airway benefit from GlideScope-assisted intubation (26,29,30). Unfortunately, randomized prehospital control trials evaluating the potential benefits of video laryngoscopy in the prehospital setting are still spare, and our results underscore that extrapolation of putative convincing manikin or in-hospital findings into the EMS world is difficult.…”

Comparison of the ETView Single Lumen and Macintosh laryngoscopes for endotracheal intubation in an airway manikin with immobilized cervical spine by novice paramedics

“…[3,4] In patients with a suspected neck trauma, cervical spine stabilization is indicated and furthermore complicates airway management. [5–7] Although controversially discussed, securing the airway using an endotracheal tube is still considered the optimal technique, although this technique requires high level of personal experience and skills. [8,9] …”

ET-View compared to direct laryngoscopy in patients with immobilized cervical spine by unexperienced physicians: A randomized crossover manikin trial

“…Based on ethical issues, this study is impossible to perform, especially with inexperienced providers. to direct laryngoscopy in patients with immobilized cervical spine [5,[19][20][21].…”