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C-MAC D-Blade and GlideScope : perhaps video will kill the direct laryngoscope star?

This article published online. Free full text downloadable from publisher website and link below ( right down the bottom)

This study consistent with previous similar studies in elective anaesthesia settings. Better views with VL but slower intubation times cw DL. However no failed intubations with VL cw some failed tubes with DL. My advice : train with both techniques. DL will cover most intubations with VL allowing a few more otherwise not achievable with DL.

Minerva Anestesiol. 2012 Oct 2. [Epub ahead of print]

Indirect videolaryngoscopy with C-MAC D-Blade and GlideScope: A randomized, controlled comparison in patients with suspected difficult airways.

Serocki GNeumann TScharf EDörges VCavus E.

Source

Department of Anaesthesiology and Intensive Care Medicine, University-Hospital Schleswig-Holstein UKSH, – serocki@anaesthesie.uni-kiel.de.

Abstract

BACKGROUND:

Recently, indirect videolaryngoscopes have become increasingly important devices in difficult airway management. The aim of the present study was to investigate laryngoscopic view and intubation success using the new C-MAC® D-Blade in comparison to the established GlideScope® videolaryngoscope and conventional direct laryngoscopy in a randomized controlled trial.

METHODS:

Ninety-six adult patients with expected difficult airways undergoing elective ear, nose and throat surgery (ENT) requiring general anaesthesia were investigated. Repeated laryngoscopy was performed using a conventional direct Macintosh laryngoscope (DL), C-MAC D-Blade (DB) and GlideScope (GS) in a randomized sequence before patients were intubated with the last device used.

RESULTS:

Both videolaryngoscopes showed significantly better C/L (Cormack-Lehane) classes than DL. Insufficient laryngoscopic view, defined as C/L A III, was experienced in 18 patients (19.2 %) with DL, in two patients with GS (2.1 %) and in none with DB (0%). Time to best achievable laryngoscopic view did not differ between devices. Intubation time was significantly longer with both videolaryngoscopes (Median [Range] DB: 18 [8-33] s, and GS: 19 [9-34] s) than with DL (11 [5-26] s). However, intubation success was 100 % for both DB and GS, whereas four patients could not be intubated using conventional direct laryngoscopy.

CONCLUSION:

Compared to direct Macintosh laryngoscopy, both C-MAC® D-Blade and GlideScope® comparably resulted in an improved view of the glottic opening with successful tracheal intubation in all patients.

PMID:

 23032922

[PubMed – as supplied by publisher]

Free Full text below
GLidescope vs CMAC vs DL Minerva Anestesiologica 2012
One Comment Post a comment
  1. This study looked at a less interesting population than critical care, ED or prehospital where the patient context is much less well controlled and the outcome stakes are possibly higher. For instance, would you tolerate the (marginally) longer intubation time in a septic obese patient who starts hypoxic and desaturates rapidly or should you opt for the (relative) certainty of a successful intubation?

    November 16, 2012

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