+ Translate
+ Most Popular
Gaucher's disease;thirty-two years experience at Siriraj Hospital
A study of Macrobathra Meyrick from China (Lepidoptera, Cosmopterigidae)
First occurrence in ores of tetragonal chalcocite
Effects of trace element nutrition on sleep patterns in adult women
N.Z. range management guidelines. 2. Design of grazing management systems for tussock country
A case of lipoma of the esophagus
A revision of world Acanthosomatidae (Heteroptera: Pentatomidae): keys to and descriptions of subfamilies, tribes and genera, with designation of types
Life history of the coronate scyphozoan Linuche unguiculata (Swartz, 1788)
Perceptual restoration of obliterated sounds
Mutagenicity studies on two chromium(III) coordination compounds
The formation of the skeleton. I. Growth of a long bone. 1st appearance of a center of calcification
Leucopenia and abnormal liver function in travellers on malaria chemoprophylaxis
The joint commission: four key root causes loom large in sentinel event data
Treatment of vitiligo with topical 15% lactic acid solution in combination with ultra violet-A
Behaviour of dairy cows within three hours after feed supply: I. Influence of housing type and time elapsing after feed supply
Observations of the propagation velocity and formation mechanism of burst fractures caused by gunshot
Management and control of patients with type 2 diabetes mellitus in Lebanon: results from the International Diabetes Management Practices Study (IDMPS)
The diet composition and nutritional knowledge of patients with anorexia nervosa
Physoporella croatica Herak, 1958 of the Slovak karst Anisian (Slovakia, the West Carpathians Mts.)
Bright lights, big noise. How effective are vehicle warning systems?
Ein Plesiosaurier-Rest mit Magensteinen aus mittlerem Lias von Quedlinburg
Incidence of Chlamydia trachomatis in patients with sterility
Monster soup: the microscope and Victorian fantasy
Preliminary tests with residual sprays against poultry lice
Duration of the life of plants in phylogeny

Direct laryngoscopy or C-MAC video laryngoscopy? Routine tracheal intubation in patients undergoing ENT surgery

Direct laryngoscopy or C-MAC video laryngoscopy? Routine tracheal intubation in patients undergoing ENT surgery

Der Anaesthesist 59(9): 806-811

ISSN/ISBN: 0003-2417

PMID: 20703441

DOI: 10.1007/s00101-010-1753-3

Previous studies have shown that video laryngoscopy enhances laryngeal view in patients with apparently normal and difficult airways. The utility of the novel, portable, battery-powered C-MAC video laryngoscope is as yet unproven. It was hypothesized that in routine patients undergoing ENT surgery, the rate of glottic views considered unsatisfactory, i.e. Cormack and Lehane grades IIb, III, and IV, could be significantly reduced with the C-MAC video laryngoscope compared to direct laryngoscopy. Following ethical approval and sample size estimates 108 consecutive patients undergoing ENT surgery under general anesthesia were studied. First, direct laryngoscopy was performed with the naked eye. The best view obtained was graded by the first anesthesiologist without looking at the video monitor. A second anesthesiologist blinded to the laryngeal view obtained under direct laryngoscopy graded the laryngeal view on the video monitor. Endotracheal intubation using Ring-Adair-Elwyn (RAE) tracheal tubes was then attempted under video-aided visualization. The tubes were not reinforced with a stylet. The C-MAC video laryngoscopy system (Karl Storz, Tuttlingen, Germany) is a novel device that can be used with Macintosh laryngoscope blades in different sizes. A camera and light source are located recessed from the tip of the blade. The camera unit sits in a handle attached to the laryngoscope blade and is connected by a wire to a TFT video monitor. It allows for both direct and indirect laryngoscopy and the low profile of the original British Macintosh blades may prove advantageous in patients with limited mouth opening. A total of 108 patients were enrolled in the study but for various reasons only 94 completed the study (post hoc power 97%). In 89 patients a size 3 Macintosh laryngoscope was used while a size 4 blade was used in the remaining 5 patients. With direct laryngoscopy the glottic view was considered unsatisfactory in 40 patients (42%), but this was the case in only 15 patients (16%) when video laryngoscopy was used (p<0.0001). Endotracheal tube placement was successful in all but one patient where the Bonfils intubation fiberscope needed to be employed. No complications related to the C-MAC system were observed. Compared to direct laryngoscopy with a Macintosh laryngoscope blade in unselected patients undergoing ENT surgery and thus patients more susceptible to an unexpected difficult airway than a general patient population, the mobile C-MAC video laryngoscope significantly enhanced laryngeal view. Using RAE tracheal tubes seems to compensate the unfavorable deviation of optical and anatomical axes when indirect laryngoscopy is performed with the C-MAC system.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 052634060

Download citation: RISBibTeXText

Related references

McGrath Video Laryngoscopy Facilitates Routine Nasotracheal Intubation in Patients Undergoing Oral and Maxillofacial Surgery: A Comparison With Macintosh Laryngoscopy. Journal of Oral and Maxillofacial Surgery: Official Journal of the American Association of Oral and Maxillofacial Surgeons 74(2): 256-261, 2016

Comparison of GlideScope Video Laryngoscopy and Direct Laryngoscopy for Tracheal Intubation in Neonates. Anesthesia and Analgesia 129(2): 482-486, 2019

Video laryngoscopy versus direct laryngoscopy for tracheal intubation during in-hospital cardiopulmonary resuscitation. Resuscitation 89: 195-199, 2015

Video laryngoscopy versus direct laryngoscopy for first-attempt tracheal intubation in the general ward. Annals of Intensive Care 8(1): 83, 2018

Expected difficult tracheal intubation: a prospective comparison of direct laryngoscopy and video laryngoscopy in 200 patients. British Journal of Anaesthesia 102(4): 546-550, 2009

Tracheal intubation in the emergency department: a comparison of GlideScope® video laryngoscopy to direct laryngoscopy in 822 intubations. Journal of Emergency Medicine 42(4): 400-405, 2012

Hemodynamic response and airway morbidity following tracheal intubation: a comparison between direct laryngoscopy, video laryngoscopy and lightwand techniques. Canadian Journal of Anesthesia/Journal canadien d'anesthésie 55(1 Supplement): 4746621-4746622, 2008

Trial sequential analysis on video laryngoscopy vs direct laryngoscopy for nasotracheal intubation in oro-maxillofacial surgery. Korean Journal of Anesthesiology 2021, 2021

Comparison of Direct Laryngoscopy and Video Laryngoscopy in Intubating a Mannequin: Should Video Laryngoscopy Be Available to Manage Airway Emergencies in the Oral and Maxillofacial Surgery Office?. Journal of Oral and Maxillofacial Surgery: Official Journal of the American Association of Oral and Maxillofacial Surgeons 73(10): 1901-1906, 2015

Video laryngoscopy vs. direct laryngoscopy for nasotracheal intubation in oromaxillofacial surgery: a systematic review and meta-analysis of randomized controlled trials. Korean Journal of Anesthesiology 74(5): 439-448, 2021

Comparison of the TruView infant EVO2 PCD™ and C-MAC video laryngoscopes with direct Macintosh laryngoscopy for routine tracheal intubation in infants with normal airways. Clinics 69(1): 23-27, 2014

Circulatory changes during direct laryngoscopy and tracheal intubation: influence of duration of laryngoscopy with or without prior lidocaine. Anesthesiology 47(4): 381-384, 1977

Is video laryngoscopy easier than direct laryngoscopy for intubation in patients with contracture neck?. Saudi Journal of Anaesthesia 14(2): 206-211, 2020

A comparison of video laryngoscopy to direct laryngoscopy for the emergency intubation of trauma patients. World Journal of Surgery 39(3): 782-788, 2015

Retrograde light-guided laryngoscopy for tracheal intubation: clinical practice and comparison with conventional direct laryngoscopy. Anesthesiology 118(5): 1059-1064, 2013