Comparison Of The Glottic View Obtained By The C-Mac Videolaryngoscope And Direct Laryngoscope In Patients With A Simulated Difficult Airway-A One Year Hospital Based Case Series Study

Abstract

OBJECTIVE: To compare the glottic visualisation by Cormack Lehane grading between Direct Laryngoscope and C MAC Videolaryngoscope in patients with a simulated difficult airway posted for surgeries under general anesthesia. METHODS: Sixty patients of either sex, between 18-60 years, undergoing elective surgeries in whom endotracheal intubation was required, were included in the study. After preoxygenation with 100% oxygen, patients were induced with IV thiopentone 5 mg kg -1 and succinyl choline 2 mg kg iv -1 . The rigid neck collar was then placed in position. The laryngeal view was assessed using Cormack and Lehane grading system. Laryngoscopy was performed with Macintosh laryngoscope first and glottic view was noted. After the withdrawal of the Macintosh blade, the grading was noted with the C-MAC videolaryngoscope. Intubation was done with the C-MAC with collar in situ, and subjectively graded as easy ( E ) or difficult ( D ) . RESULTS: It was found that grade III and IV ( RESTRICTED VIEW ) with Macintosh laryngoscope was 76.7% ( 46/60) compared to 23.3% ( 14/60) with the C- MAC. With the use of CMAC Videolaryngoscope, glottic view improved by 1 CL grade in 43.3% ( 26pts) , by 2 CL grades in 21.6% ( 13pts) and by 3 CL grades in 1.6% ( 1pt ) of patients. For intubation with C-MAC with the neck collar in situ, intubation was easy ( E ) in 44 cases ( 73.3% ) and difficult in 16( 26.7% ) . CONCLUSION: C-MAC videolaryngoscope significantly improved the glottic view in simulated difficult airways compared to the conventional Macintosh laryngoscope.