A randomised, controlled crossover comparison of the C-MAC videolaryngoscope with direct laryngoscopy in 150 patients during routine induction of anaesthesia

BMC Anesthesiology

Research Article

Klaus Wagner¹  Thora Moeller²  Joerg Kieckhaefer²  Erol Cavus³  Volker Doerges⁴  Carsten Thee⁵ 

[1] Associate Professor of Anaesthesiology and chair, Department of Anaesthesiology and Intensive Care Medicine, Suedstadt Hospital Rostock, Suedring 81, 18059, Rostock, Germany;Consultant in Anaesthesiology, Department of Anaesthesiology and Intensive Care Medicine, Suedstadt Hospital Rostock, Suedring 81, 18059, Rostock, Germany;Consultant in Anaesthesiology, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, 24105, Kiel, Germany;Professor of Anaesthesiology, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, 24105, Kiel, Germany;Resident, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, 24105, Kiel, Germany;

关键词: Difficult Airway;    Direct Laryngoscopy;    Intubation Success;    Intubation Attempt;    Macintosh Laryngoscope;   

DOI  :  10.1186/1471-2253-11-6

 received in 2010-05-19, accepted in 2011-03-01,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe C-MAC® (Karl Storz, Tuttlingen, Germany) has recently been introduced as a new device for videolaryngoscopy guided intubation. The purpose of the present study was to compare for the first time the C-MAC with conventional direct laryngoscopy in 150 patients during routine induction of anaesthesia.MethodsAfter approval of the institutional review board and written informed consent, 150 patients (ASA I-III) with general anaesthesia were enrolled. Computer-based open crossover randomisation was used to determine the sequence of the three laryngoscopies: Conventional direct laryngoscopy (HEINE Macintosh classic, Herrsching, Germany; blade sizes 3 or 4; DL group), C-MAC size 3 (C-MAC3 group) and C-MAC size 4 (C-MAC4 group) videolaryngoscopy, respectively. After 50 patients, laryngoscopy technique in the C-MAC4 group was changed to the straight blade technique described by Miller (C-MAC4/SBT).ResultsIncluding all 150 patients (70 male, aged (median [range]) 53 [20-82] years, 80 [48-179] kg), there was no difference of glottic view between DL, C-MAC3, C-MAC4, and C-MAC4/SBT groups; however, worst glottic view (C/L 4) was only seen with DL, but not with C-MAC videolaryngoscopy. In the subgroup of patients that had suboptimal glottic view with DL (C/L≥2a; n = 24), glottic view was improved in the C-MAC4/SBT group; C/L class improved by three classes in 5 patients, by two classes in 2 patients, by one class in 8 patients, remained unchanged in 8 patients, or decreased by two classes in 1 patient. The median (range) time taken for tracheal intubation in the DL, C-MAC3, C-MAC4 and C-MAC4/SBT groups was 8 sec (2-91 sec; n = 44), 10 sec (2-60 sec; n = 37), 8 sec (5-80 sec; n = 18) and 12 sec (2-70 sec; n = 51), respectively.ConclusionsCombining the benefits of conventional direct laryngoscopy and videolaryngoscopy in one device, the C-MAC may serve as a standard intubation device for both routine airway management and educational purposes. However, in patients with suboptimal glottic view (C/L≥2a), the C-MAC size 4 with straight blade technique may reduce the number of C/L 3 or C/L 4 views, and therefore facilitate intubation. Further studies on patients with difficult airway should be performed to confirm these findings.

【 授权许可】

CC BY   
© Cavus et al; licensee BioMed Central Ltd. 2011