Comparison of the C-MAC video laryngoscope to a flexible fiberoptic scope for intubation with cervical spine immobilization

Yumul, Roya; Elvir-Lazo, Ofelia Loani; White, Paul F.; Durra, Omar; Ternian, Alen; Tamman, Richard; Naruse, Robert; Ebba, Hailu; Yusufali, Taizoon; Wong, Ruby M.; Conte, Antonio Hernandez; Farnad, Shahbaz; Pham, Christopher H; Wender, Ronald H.

doi:10.1016/j.jclinane.2015.12.045

Cited by 27 publications

(26 citation statements)

References 26 publications

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“…It has many advantages such as similarities to the conventional laryngoscopy, and more familiarity to psychomotor skills [ 6 ]. A recent study reported that the C-MAC video laryngoscope offers an advantage over the flexible fiberoptic scope with respect to the time required to obtain a glottic view and successful placement of the tracheal tube in patients with cervical spine immobilization [ 7 ]. In addition, Shirgoska and Netkovski [ 8 ] suggested that video laryngoscopy can be easily learned and should be used for managing difficult airway situations in the operating room, as well as in the emergency department.…”

Section: Discussionmentioning

confidence: 99%

Awake intubation in a patient with huge orocutaneous fistula: a case report

Kim

et al. 2017

J Dent Anesth Pain Med

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Mask ventilation, the first step in airway management, is a rescue technique when endotracheal intubation fails. Therefore, ordinary airway management for the induction of general anesthesia cannot be conducted in the situation of difficult mask ventilation (DMV). Here, we report a case of awake intubation in a patient with a huge orocutaneous fistula. A 58-year-old woman was scheduled to undergo a wide excision, reconstruction with a reconstruction plate, and supraomohyoid neck dissection on the left side and an anterolateral thigh flap due to a huge orocutaneous fistula that occurred after a previous mandibulectomy and flap surgery. During induction, DMV was predicted, and we planned an awake intubation. The patient was sedated with dexmedetomidine and remifentanil. She was intubated with a nasotracheal tube using a video laryngoscope, and spontaneous ventilation was maintained. This case demonstrates that awake intubation using a video laryngoscope can be as good as a fiberoptic scope.

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Section: Discussionmentioning

confidence: 99%

Awake intubation in a patient with huge orocutaneous fistula: a case report

Kim

et al. 2017

J Dent Anesth Pain Med

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“…Among these, we identified and retrieved 18 randomized clinical trials for inclusion evaluating 1972 patients ( Figure 1). Table 1 Three trials were judged to be at low risk of bias, 12-14 13 at unclear risk [15][16][17][18][19][20][21][22][23][24][25][26][27] and 2 at high risk. 28,29 Random sequence generation was assessed as low risk of bias in 16 trials, allocation concealment in 9 trials, completeness of outcome data in 8 trials, selective outcome reporting in 4 trials and other bias in 15 trials ( Figure 2 and Figure S1, Table S2).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In the remaining 14 RCTs, [12][13][14][18][19][20][21][22][23][24][25][26]28,29 intubation was performed under general anesthesia after administration of sedative and neuromuscular blocking agents. Since the evaluated techniques were highly heterogeneous, we decided to perform two main meta-analytic comparisons focused on the devices commonly available in the operating room: (a) direct, traditional Macintosh laryngoscopy versus other techniques (three RCTs; Figure 2) and (b) videolaryngoscopy versus other techniques (five RCTs; Figure 3).…”

Section: Ta B L E 1 (Continued)mentioning

confidence: 99%

Tracheal intubation in patients at risk for cervical spinal cord injury: A systematic review

Cabrini

Redaelli

Filippini

et al. 2019

Acta Anaesthesiol Scand

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Background: Tracheal intubation in patients at risk for secondary spinal cord injury is potentially difficult and risky. Objectives: To compare tracheal intubation techniques in adult patients at risk for secondary cervical spinal cord injury undergoing surgery. Primary outcome was firstattempt failure rate. Secondary outcomes were time to successful intubation and procedure complications. Design: Systematic review and meta-analysis of randomized controlled trials (RCTs) with trial sequential analysis (TSA). Data Sources: Databases searched up to July 2019. Eligibility: Randomized controlled trials comparing different intubation techniques. Results: We included 18 trials enrolling 1972 patients. Four studies used the "awake" approach, but no study compared awake versus non-awake techniques. In remaining 14 RCTs, intubation was performed under general anesthesia. First-attempt failure rate was similar when comparing direct laryngoscopy or fiberoptic bronchoscopy versus other techniques. A better first-attempt failure rate was found with videolaryngoscopy and when pooling all the fiberoptic techniques together. All these results appeared not significant at TSA, suggesting inconclusive evidence. Intubating lighted stylet allowed faster intubation. Postoperative neurological complications were 0.34% (no significant difference among techniques). No life-threatening adverse event was reported; mild local complications were common (19.5%). The certainty of evidence was low to very low mainly due to high imprecision and indirectness. Conclusions: Videolaryngoscopy and fiberoptic-assisted techniques might be associated with higher first-attempt failure rate over controls. However, low to very low certainty of evidence does not allow firm conclusions on the best tracheal intubation in patients at risk for cervical spinal cord injury.

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“…Perbedaan ini disebabkan oleh perbedaan subjek penelitian, yaitu pasien dengan variasi anatomis yang berbeda dan angka keberhasilan dalam penelitian ditentukan dengan 1 kali percobaan (first attempt intubation). 14 Angka keberhasilan intubasi yang tinggi mempergunakan purwarupa camera-bougie disebabkan oleh purwarupa ini memiliki kelenturan untuk dibentuk dan diarahkan seperti bougie dan memberikan visualisasi laring atau plica vocalis pada saat intubasi dilakukan. Kemampuan purwarupa camerabougie untuk memberikan gambar visual akan mengatasi kesulitan visualisasi laring saat laringoskopi direk yang merupakan penyebab utama penatalaksanaan jalan napas sulit.…”

Section: Subjek Dan Metodeunclassified

Perbandingan Angka Keberhasilan Intubasi dan Waktu Intubasi antara Menggunakan Bougie dan Purwarupa Camera–Bougie pada Maneken Simulasi Kesulitan Intubasi

Amelis¹,

Budipratama²,

Oktaliansah³

2019

jap

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Penatalaksanaan jalan napas merupakan hal fundamental bagi ahli anestesi. Kegagalan penatalaksanaan jalan napas mengakibatkan kematian. Berbagai modalitas tersedia untuk penatalaksanaan jalan napas sulit, mulai dari alat sederhana seperti stylet dan bougie hingga alat canggih seperti video laryngsocope dan fiberoptic. Fiberoptik masih menjadi standar baku kesulitan intubasi, namun penggunaannya masih terbatas karena harganya mahal dan penggunaannya sulit. Purwarupa camera–bougie merupakan modalitas baru yang diharapkan dapat mengatasi keterbatasan tersebut dan menjembatani antara bougie yang sederhana dan fiberoptik yang sangat canggih. Tujuan penelitian adalah membandingkan angka keberhasilan intubasi dan waktu intubasi antara bougie dan purwarupa camera–bougie pada maneken simulasi kesulitan intubasi di RSUP Dr. Hasan Sadikin Bandung. Penelitian analitik eksperimental ini dilakukan pada 41 peserta didik Program Pendidikan Dokter Spesialis (PPDS) Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadaran/RSUP Dr. Hasan Sadikin Bandung semester 5 sampai dengan 11 yang melakukan intubasi dengan bougie dan purwarupa camera–bougie secara bergantian dengan metode randomisasi permutasi blok pada maneken simulasi kesulitan intubasi. Penelitian dilakukan dari tanggal 16–24 Oktober 2018. Keberhasilan dan waktu intubasi dicatat dan dianalisis secara statistik dengan Uji Mc. Nemar dan Wilcoxon. Keberhasilan intubasi dengan bougie sebesar 39% dan purwarupa camera-bougie 100% (p<0,001). Waktu intubasi dengan bougie dan purwarupa camera-bougie sebesar 18,81 (12,19) detik dan 7,0 (1,47) detik (p<0,001). Simpulan, purwarupa camera–bougie meningkatkan keberhasilan intubasi dan memperpendek waktu intubasi pada maneken simulasi kesulitan intubasi.Comparison of Success Rate and Duration of Intubation between Bougie and Bougie–Camera Prototype in Simulated Difficult Airway ManikinAirway management is fundamental for anesthesiologist. Fiberoptic is still the gold standard for difficult intubation but its expensive price and complicated handling limit its use. Bougie–camera prototype is one of the new modalities that is expected to overcome these limitations and bridge the gap between simple bougie and very sophisticated fiberoptic. The aim of this study was to compare the success rate and duration of intubation between bougie and bougie–camera prototype in simulated difficult airway manikin at Dr. Hasan Sadikin General Hospital Bandung. This experimental analytic study was conducted on 41 fifth semester anesthesiology residents of the Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital who performed intubation with bougie and bougie–camera prototype alternately on simulated difficult airway mannequin using permutation block randomization method. This study was held during the period of 16–24th of October 2018. The success rate and duration of intubation were recorded and analyzed statistically by Mc. Nemar and Wilcoxon tests. The rate of successful intubation with bougie was 39% and 100% with bougie–camera prototype (p<0.001). Duration of intubation with bougie and bougie–camera prototype was 18.81 (12.19) seconds and 7.0 (1.47) seconds (p<0.001). The conclusion of this study is bougie–camera prototype increases the success rate of intubation and shortens the duration of intubation on simulated difficult airway on mannequin.

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Comparison of the C-MAC video laryngoscope to a flexible fiberoptic scope for intubation with cervical spine immobilization

Abstract: The C-MAC may offer an advantage over the FFS with respect to the time required to obtain glottic view and successful placement of the tracheal tube in patients requiring cervical spine immobilization.

Cited by 27 publications

References 26 publications

Awake intubation in a patient with huge orocutaneous fistula: a case report

Awake intubation in a patient with huge orocutaneous fistula: a case report

Tracheal intubation in patients at risk for cervical spinal cord injury: A systematic review

Perbandingan Angka Keberhasilan Intubasi dan Waktu Intubasi antara Menggunakan Bougie dan Purwarupa Camera–Bougie pada Maneken Simulasi Kesulitan Intubasi

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