Comparison of the C-MACTM ‘D’ blade with AirTraq® for endotracheal intubation in patients with simulated limitation of cervical movements

Abstract

Background: Direct laryngoscopy and tracheal intubation with manual in-line stabilisation is the standard practice for trauma victims while securing the airway when cervical injury/instability is suspected. The use of videolaryngoscopes eliminates the need to align the three axes, avoids movement at cervical joints, allows viewing around the corner and improves glottic view. Aim: Comparison of C-MACTM‘D’Blade and AirTraq® for endotracheal intubation in patients with simulated limitation of cervical movements. Methodology: This was a prospective, randomised study conducted on 52 consenting patients requiring intubation. They were assigned to undergo intubation using C-MACTM‘D’Blade (n=26) or AirTraq® (n=26) by an anaesthesiologist experienced in the use of both laryngoscopes while MILS was provided. Results: Laryngoscopic view was similar in the two groups: grade 1 in 16 (61.5%) and 21 patients (81.8%) in the ‘D’blade and AirTraq® groups respectively with the remaining having a grade 2 view. The median time for laryngoscopy was less (13 s) in the ‘D’ blade compared to AirTraq® group (19.6 s) and was statistically significant (p= 0.036) but clinically insignificant. The intubation time was comparable (p=0.094). Most patients in both groups were intubated successfully in the first attempt. Requirement of airway manipulation to optimise view, postoperative sore throat and blood on the endotracheal tube was comparable. Good overall satisfaction score was obtained in bothgroups. Conclusion: Both C-MACTM ‘D’Blade and AirTraq® when used for intubation in patients with simulated limitation of cervical movements provide similar videolaryngoscopic view, time for laryngoscopy and intubation, and overall satisfaction score.