Effectiveness of C-MAC video-stylet versus C-MAC D-blade video-laryngoscope for tracheal intubation in patients with predicted difficult airway: Randomized comparative study

Background This prospective study was done on patients with suspected difficult airway to compare between C-MAC video-stylet (VS) and D-blade video-laryngoscope for tracheal intubation. Patients and methodology Randomization was done on 160 adult patients with anticipated difficulty in intubation for different causes to divide them into two equal groups (VS group and D group). Patients in each group were divided into five categories according to the cause of anticipated intubation difficulty. Duration of intubation, number of attempts, and success intubation rate were recorded. Hemodynamics parameters were measured before intubation as baseline, then after intubation at 1 and 5 min. Results In VS group, intubation time ranged between 23 and 166 s with mean of 53.2 +/- 24.19 s and in D group it ranged between 30 and 279 s with mean of 65.5 +/- 40.63 s (P-value 0.021). This shorter intubation time was not constant in different patient's categories. The first attempt intubation was successfully done in 68 patients (85%) in VS group versus 61 patients (76.3%) in D group. Hemodynamically, HR and MABP showed significant increase in D group more than in VS group at 1 and 5 min after intubation (P-value = 0.001). Conclusion Both devices are helpful when there is a risk of difficult intubation. C-MAC VS is a better choice in cases of limited mouth opening and obesity, but in cases of limited cervical motility, the use of C-MAC D-blade is a better choice with a faster intubation time.

Automated summary

This study compares the application of C-MAC video-stylet and D-blade video-laryngoscope in tracheal intubation for patients with suspected difficult airway. The results show that the intubation time is significantly shorter with C-MAC video-stylet compared to D-blade video-laryngoscope, and the increase in heart rate and mean arterial blood pressure after intubation is more significant with D-blade video-laryngoscope. Different devices should be chosen based on the patient's condition.