A randomised, controlled crossover comparison of the C-MAC videolaryngoscope with direct laryngoscopy in 150 patients during routine induction of anaesthesiaReport as inadecuate




A randomised, controlled crossover comparison of the C-MAC videolaryngoscope with direct laryngoscopy in 150 patients during routine induction of anaesthesia - Download this document for free, or read online. Document in PDF available to download.

BMC Anesthesiology

, 11:6

First Online: 01 March 2011Received: 19 May 2010Accepted: 01 March 2011

Abstract

BackgroundThe C-MAC Karl Storz, Tuttlingen, Germany has recently been introduced as a new device for videolaryngoscopy guided intubation. The purpose of the present study was to compare for the first time the C-MAC with conventional direct laryngoscopy in 150 patients during routine induction of anaesthesia.

MethodsAfter approval of the institutional review board and written informed consent, 150 patients ASA I-III with general anaesthesia were enrolled. Computer-based open crossover randomisation was used to determine the sequence of the three laryngoscopies: Conventional direct laryngoscopy HEINE Macintosh classic, Herrsching, Germany; blade sizes 3 or 4; DL group, C-MAC size 3 C-MAC3 group and C-MAC size 4 C-MAC4 group videolaryngoscopy, respectively. After 50 patients, laryngoscopy technique in the C-MAC4 group was changed to the straight blade technique described by Miller C-MAC4-SBT.

ResultsIncluding all 150 patients 70 male, aged median range 53 20-82 years, 80 48-179 kg, there was no difference of glottic view between DL, C-MAC3, C-MAC4, and C-MAC4-SBT groups; however, worst glottic view C-L 4 was only seen with DL, but not with C-MAC videolaryngoscopy. In the subgroup of patients that had suboptimal glottic view with DL C-L≥2a; n = 24, glottic view was improved in the C-MAC4-SBT group; C-L class improved by three classes in 5 patients, by two classes in 2 patients, by one class in 8 patients, remained unchanged in 8 patients, or decreased by two classes in 1 patient. The median range time taken for tracheal intubation in the DL, C-MAC3, C-MAC4 and C-MAC4-SBT groups was 8 sec 2-91 sec; n = 44, 10 sec 2-60 sec; n = 37, 8 sec 5-80 sec; n = 18 and 12 sec 2-70 sec; n = 51, respectively.

ConclusionsCombining the benefits of conventional direct laryngoscopy and videolaryngoscopy in one device, the C-MAC may serve as a standard intubation device for both routine airway management and educational purposes. However, in patients with suboptimal glottic view C-L≥2a, the C-MAC size 4 with straight blade technique may reduce the number of C-L 3 or C-L 4 views, and therefore facilitate intubation. Further studies on patients with difficult airway should be performed to confirm these findings.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2253-11-6 contains supplementary material, which is available to authorized users.

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Author: Erol Cavus - Carsten Thee - Thora Moeller - Joerg Kieckhaefer - Volker Doerges - Klaus Wagner

Source: https://link.springer.com/







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