Endotracheal intubation using direct laryngoscopy with Macintosh blade versus C-MAC videolaryngoscopy (Macintosh blade and D-blade)

BackgroundDirect laryngoscopes have been developed to many optical fiberscopes to provide better view of the glottis without alignment of the oral, pharyngeal and tracheal axes. Recently, videolaryngoscopes have become increasingly important devices in difficult airway management.PurposeThe aim of the present study was to compare the efficacy of direct laryngoscopy using a conventional Macintosh blade with C-MAC videolaryngoscopy (with a Macintosh blade or D-blade), and to select the device of choice for the best first attempt for laryngoscopy and endotracheal intubation.Patients and methodsA total of 90 adult patients were randomly categorized into three equal groups (30 patients each): group I, in which patients were subjected to general anaesthesia with endotracheal intubation using direct laryngoscopy with conventional Macintosh blade; group II, in which patients were subjected to general anaesthesia with endotracheal intubation using C-MAC videolaryngoscopy with conventional Macintosh blade; and group III, in which patients were subjected to general anaesthesia with endotracheal intubation using C-MAC videolaryngoscopy with the D-blade. Then, the assessment of the laryngoscopic view and the whole procedure of laryngoscopy and intubation was carried out.ConclusionThis study validated the efficacy of C-MAC Macintosh blade and D-blade when compared with a direct laryngoscope. D-Blade has been found to be more effective in reducing haemodynamic responses to laryngoscopy and intubation. Its use improves the laryngoscopic view with a high success rate, makes the procedure of laryngoscopy and intubation easier from the first attempt and involves the least usage of assisting manoeuvres while achieving the shortest ETT insertion time without any complications.