Diabetes Mellitus Olan Hastalarda C-MAC Video Laringoskop ve Macintosh Laringoskopun Elektif Trakeal Entübasyon İçin Karşılaştırılması: Randomize Kontrollü Çalışma

Abstract

Objective: C-MAC video laryngoscope and Macintosh direct laryngoscope were compared in terms of intubation conditions, during elective tracheal intubation in patients with diabetes mellitus (DM) who have a high risk for difficult airway. Material and Methods: One hundred and ten American Society of Anesthesiologist physical class II-III patients with DM undergoing elective surgery were randomized to be intubated using C-MAC video laryngoscope or Macintosh laryngoscope. Glottic view Cormack Lehane (CL) score, intubation time, intubation difficulty scale (IDS) score, and first attempt intubation success were compared. Results: Similar intubation times were detected [Macintosh laryngoscope: 39.6±30.1 seconds; C-MAC: 46.7±35.4 seconds (p=0.098). C-MAC provided significantly better CL scores]. Grade 1 CL laryngeal view was observed in 37 (68%) C-MAC vs. 26 (47.3%) Macintosh laryngoscope intubations (p=0.04). An IDS score of >5 was determined in 11 (20.4%) patients with C-MAC and in 10 (18.2%) with Macintosh laryngoscope (p=0.04), indicating an overall 20.1% moderate-to-severe intubation difficulty (p=0.536). The mean IDS score was 3.2±2.9 and 2.4±3.3 with C-MAC and Macintosh laryngoscopes, (p=0.04). First-attempt intubation success was 83.3% vs. 87.0% with C-MAC vs. Macintosh laryngoscope (p=0.786). Conclusion: In patients with DM, CMAC provided improved glottis visualization, similar intubation time and first-attempt intubation success as a first-attempt intubation device compared with the Macintosh laryngoscope. However IDS scores were higher with the C-MAC. The incidence of actual intubation difficulty was found 20.1% in this diabetic study population.