Factors Influencing the Time of Intubation Using C-MAC D-Blade® Video Laryngoscope: An Observational Cross-Sectional Study

Abstract

C-MAC D-Blade® (Karl Storz, Tuttlingen, Germany) video laryngoscope (VL) has proved to be of immense utility in difficult intubation. But unfortunately, in an urgent situation, the predictable correct curvature of the endotracheal tube for effortless intubation is not met. We hypothesized that expertise is the most important variable in intubation and that novice students will be unable to intubate if the angle of curvature is incorrect. MethodsAn observational cross-sectional study was planned with 30 anesthesia residents, categorized into three groups based on their expertise in laryngoscopy. Students had to intubate an airway mannequin using the C-MAC D-Blade® VL with three different stylet angulations. The curvatures were 80, 100, and 120 degrees, which are commonly encountered in routine day-to-day practice. The time to get a stable glottic view, time to intubate, and ease of intubation were measured. ResultsThe mean time to intubate was the least with 100-degree angulation in group C (19.60 ± 0.97) while the maximum time was in group A with 80-degree angulation (61.49 ± 3.69). A significant difference was noted in time to get a stable glottic view when compared between the groups. There was no difference in time to intubate with different stylet angulations when compared between groups. ConclusionsNovices and experts could intubate even if the angle of curvature was incorrect taking more time. The time to laryngoscopy is significantly dependent on experience, but the time to intubate is influenced by the angle of curvature of the stylet.

Styletubation versus Laryngoscopy: A New Paradigm for Routine Tracheal Intubation

“…Even VL offers better glottic entrance visualization and intubation conditions, a good laryngeal view does not guarantee easy or successful tracheal tube insertion and might be VL-blade geometry-dependent [84]. Although the time to intubate using VL is significantly dependent on operator's experience and skills, such time is also influenced by, e.g., the angle of curvature of the stylet [85].…”

Styletubation versus Laryngoscopy: A New Paradigm for Routine Tracheal Intubation

“…Even though the VL offers better glottic entrance visualization and intubation conditions, a good laryngeal view does not guarantee easy or successful tracheal tube insertion and might be VL blade geometrydependent [84]. Although the time to intubate using a VL is significantly dependent on operator's experience and skills, such time is also influenced by, e.g., the angle of curvature of the stylet [85].…”