A comparative study of the C-MAC D-blade videolaryngoscope and McCoy laryngoscope for oro-tracheal intubation with manual in-line stabilization of neck in patients undergoing cervical spine surgery
Background and Aims: Airway management in cervical spine injury patients requires manual in-line stabilization (MILS) of the neck to avoid exacerbation of cord injury, which impedes visualization of glottis during laryngoscopy. Specially designed blades such as McCoy and C-MAC D-blades can improve l...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Journal of Anaesthesiology Clinical Pharmacology |
| Subjects: | |
| Online Access: | http://www.joacp.org/article.asp?issn=0970-9185;year=2023;volume=39;issue=3;spage=435;epage=443;aulast=Kumari |
| _version_ | 1827309093959761920 |
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| author | Astha Kumari Pratiti Choudhuri Nidhi Agrawal |
| author_facet | Astha Kumari Pratiti Choudhuri Nidhi Agrawal |
| author_sort | Astha Kumari |
| collection | DOAJ |
| description | Background and Aims: Airway management in cervical spine injury patients requires manual in-line stabilization (MILS) of the neck to avoid exacerbation of cord injury, which impedes visualization of glottis during laryngoscopy. Specially designed blades such as McCoy and C-MAC D-blades can improve laryngoscopic view in such patients. This study was performed to compare the efficacy of C-MAC D-blades and the McCoy laryngoscope for oro-tracheal intubation using MILS in patients undergoing cervical spine surgery.
Material and Methods: This randomized, prospective study was performed in 60 adult patients of American Society of Anesthesiologists grade I–III, either sex, 18 to 60 years of age undergoing elective cervical spine surgery. Patients were randomly categorized into two groups, group D and group M. Intubation was performed using a C-MAC D-blade videolaryngoscope in group D and a McCoy laryngoscope in group M using MILS. The intubation difficulty scale (IDS) score, laryngoscopy and intubation times, percentage of glottic opening (POGO) score, Cormack Lehane (CL) grading with and without external laryngeal pressure (ELP), need for bougie or change of blade or operator, and change in hemodynamics following intubation were recorded.
Results: Group D showed lower mean IDS scores than group M (P value < 0.0001). There were statistically significant differences found in duration of laryngoscopy (group D < group M), CL grading without ELP (group D: CL-1,2a >CL-2b, 3; group M: CL-1,2a <CL-2b, 3), mean POGO scores without ELP (group D > group M), need for ELP and lifting force (group D < group M), and hemodynamic responses after intubation (group D < group M).
Conclusion: A C-MAC D-blade videolaryngoscope provides better and rapid visualization of glottis with less intubation difficulties than a McCoy laryngoscope during intubation using MILS in patients with cervical spine injury. |
| first_indexed | 2024-03-11T15:43:24Z |
| format | Article |
| id | doaj.art-a11d5e1114f54f9488d42df098475e35 |
| institution | Directory Open Access Journal |
| issn | 0970-9185 |
| language | English |
| last_indexed | 2024-04-24T19:25:31Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Anaesthesiology Clinical Pharmacology |
| spelling | doaj.art-a11d5e1114f54f9488d42df098475e352024-03-25T15:51:28ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852023-01-0139343544310.4103/joacp.joacp_471_21A comparative study of the C-MAC D-blade videolaryngoscope and McCoy laryngoscope for oro-tracheal intubation with manual in-line stabilization of neck in patients undergoing cervical spine surgeryAstha KumariPratiti ChoudhuriNidhi AgrawalBackground and Aims: Airway management in cervical spine injury patients requires manual in-line stabilization (MILS) of the neck to avoid exacerbation of cord injury, which impedes visualization of glottis during laryngoscopy. Specially designed blades such as McCoy and C-MAC D-blades can improve laryngoscopic view in such patients. This study was performed to compare the efficacy of C-MAC D-blades and the McCoy laryngoscope for oro-tracheal intubation using MILS in patients undergoing cervical spine surgery. Material and Methods: This randomized, prospective study was performed in 60 adult patients of American Society of Anesthesiologists grade I–III, either sex, 18 to 60 years of age undergoing elective cervical spine surgery. Patients were randomly categorized into two groups, group D and group M. Intubation was performed using a C-MAC D-blade videolaryngoscope in group D and a McCoy laryngoscope in group M using MILS. The intubation difficulty scale (IDS) score, laryngoscopy and intubation times, percentage of glottic opening (POGO) score, Cormack Lehane (CL) grading with and without external laryngeal pressure (ELP), need for bougie or change of blade or operator, and change in hemodynamics following intubation were recorded. Results: Group D showed lower mean IDS scores than group M (P value < 0.0001). There were statistically significant differences found in duration of laryngoscopy (group D < group M), CL grading without ELP (group D: CL-1,2a >CL-2b, 3; group M: CL-1,2a <CL-2b, 3), mean POGO scores without ELP (group D > group M), need for ELP and lifting force (group D < group M), and hemodynamic responses after intubation (group D < group M). Conclusion: A C-MAC D-blade videolaryngoscope provides better and rapid visualization of glottis with less intubation difficulties than a McCoy laryngoscope during intubation using MILS in patients with cervical spine injury.http://www.joacp.org/article.asp?issn=0970-9185;year=2023;volume=39;issue=3;spage=435;epage=443;aulast=Kumaric-maccormack-lehaneidsmccoymilspogovideolaryngoscope |
| spellingShingle | Astha Kumari Pratiti Choudhuri Nidhi Agrawal A comparative study of the C-MAC D-blade videolaryngoscope and McCoy laryngoscope for oro-tracheal intubation with manual in-line stabilization of neck in patients undergoing cervical spine surgery Journal of Anaesthesiology Clinical Pharmacology c-mac cormack-lehane ids mccoy mils pogo videolaryngoscope |
| title | A comparative study of the C-MAC D-blade videolaryngoscope and McCoy laryngoscope for oro-tracheal intubation with manual in-line stabilization of neck in patients undergoing cervical spine surgery |
| title_full | A comparative study of the C-MAC D-blade videolaryngoscope and McCoy laryngoscope for oro-tracheal intubation with manual in-line stabilization of neck in patients undergoing cervical spine surgery |
| title_fullStr | A comparative study of the C-MAC D-blade videolaryngoscope and McCoy laryngoscope for oro-tracheal intubation with manual in-line stabilization of neck in patients undergoing cervical spine surgery |
| title_full_unstemmed | A comparative study of the C-MAC D-blade videolaryngoscope and McCoy laryngoscope for oro-tracheal intubation with manual in-line stabilization of neck in patients undergoing cervical spine surgery |
| title_short | A comparative study of the C-MAC D-blade videolaryngoscope and McCoy laryngoscope for oro-tracheal intubation with manual in-line stabilization of neck in patients undergoing cervical spine surgery |
| title_sort | comparative study of the c mac d blade videolaryngoscope and mccoy laryngoscope for oro tracheal intubation with manual in line stabilization of neck in patients undergoing cervical spine surgery |
| topic | c-mac cormack-lehane ids mccoy mils pogo videolaryngoscope |
| url | http://www.joacp.org/article.asp?issn=0970-9185;year=2023;volume=39;issue=3;spage=435;epage=443;aulast=Kumari |
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