Disposable vs re-usable C-MAC ® blades.

Abstract

I have had similar problems with the disposable C-MAC® videolaryngoscope blade (Karl Storz, Tuttlingen, Germany) to those reported by Greenland 1. Having sucessfully intubated the trachea of the same patient twice previously using a re-usable version of the blade and a tracheal tube introducer, I was unable to intubate the trachea using a disposable blade when the patient presented a third time, even though there was a Cormack and Lehane grade-3b view 2 on direct laryngoscopy on all three occasions. Like Greenland, I noticed a significant reduction in the workable pharyngeal space with the disposable blade compared with the re-usable blades, probably due to the marked thickness of the disposable plastic blade. I believe a ‘blind spot’ 1 may have also contributed to the reduced pharyngeal space, making manipulation of the tracheal tube with or without the adjuvant introducer difficult. I agree that a comparative study of disposable and re-usable blades is necessary. The manufacturers need to consider making disposable metal blades with an appropriate contour to reduce the thickness of the blade and the ‘blind spot.’ Until these issues are resolved, re-usable blades should be retained for use in cases where intibation is not possible using disposable blades.