A Comparison of McGrath MAC Versus C-MAC Videolaryngoscopes in Morbidly Obese Patients Undergoing Bariatric Surgery: A Randomized, Controlled Clinical Trial

Abstract

Introduction: Airway management in morbidly obese patients is a technical challenge for the anesthesiologists. In this study, we aimed to compare the McGrath MAC with C-MAC videolaryngoscopes for tracheal intubation in morbidly obese patients. Materials and Methods: Eighty morbidly obese patients, scheduled for bariatric surgery, were randomly allocated to two study groups: McGrath-MAC® and C-MAC®. The preoperative airway assessment, incidence and attempts for successful intubation, time to intubation, position for successful intubation, percentage of glottic opening (POGO score), ease of intubation, hemodynamic response, and adverse events of tracheal intubation were recorded. Results: Incidence and attempts for successful intubation and position for successful intubation were similar. Time to intubation was significantly shorter in C-MAC than McGrath (p < 0.001). The POGO scores were similar in both groups (p = 0.057). The heart rate and mean arterial pressure of McGrath was significantly higher than C-MAC after tracheal intubation at first minute (p = 0.002). Also adverse events of tracheal intubation were similar. Conclusions: Both devices were efficient and improved the glottic view. However, the C-MAC demonstrated shorter tracheal intubation times, better glottic visualization, and less hemodynamic response than the McGrath. We, therefore, conclude that the C-MAC videolaryngoscope may contribute advantages in performing tracheal intubations in morbidly obese patients.