Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 3 , ISSUE 1 ( January-June, 2014 ) > List of Articles

Original Article

Comparison of the C-MACTM ‘D’ blade with AirTraq® for endotracheal intubation in patients with simulated limitation of cervical movements

Madhu Rao, N Nandeesha

Keywords : AirTraq®, C-MAC, D Blade, endotracheal intubation, limited cervical movements

Citation Information : Rao M, Nandeesha N. Comparison of the C-MACTM ‘D’ blade with AirTraq® for endotracheal intubation in patients with simulated limitation of cervical movements. Indian J Respir Care 2014; 3 (1):357-363.

DOI: 10.5005/ijrc-3-1-357

License: NA

Published Online: 01-12-2022

Copyright Statement:  NA


Abstract

Background: Direct laryngoscopy and tracheal intubation with manual in-line stabilisation is the standard practice for trauma victims while securing the airway when cervical injury/instability is suspected. The use of videolaryngoscopes eliminates the need to align the three axes, avoids movement at cervical joints, allows viewing around the corner and improves glottic view. Aim: Comparison of C-MACTM‘D’Blade and AirTraq® for endotracheal intubation in patients with simulated limitation of cervical movements. Methodology: This was a prospective, randomised study conducted on 52 consenting patients requiring intubation. They were assigned to undergo intubation using C-MACTM‘D’Blade (n=26) or AirTraq® (n=26) by an anaesthesiologist experienced in the use of both laryngoscopes while MILS was provided. Results: Laryngoscopic view was similar in the two groups: grade 1 in 16 (61.5%) and 21 patients (81.8%) in the ‘D’blade and AirTraq® groups respectively with the remaining having a grade 2 view. The median time for laryngoscopy was less (13 s) in the ‘D’ blade compared to AirTraq® group (19.6 s) and was statistically significant (p= 0.036) but clinically insignificant. The intubation time was comparable (p=0.094). Most patients in both groups were intubated successfully in the first attempt. Requirement of airway manipulation to optimise view, postoperative sore throat and blood on the endotracheal tube was comparable. Good overall satisfaction score was obtained in bothgroups. Conclusion: Both C-MACTM ‘D’Blade and AirTraq® when used for intubation in patients with simulated limitation of cervical movements provide similar videolaryngoscopic view, time for laryngoscopy and intubation, and overall satisfaction score.


HTML PDF Share
  1. Sawin PD, Todd MM, Traynelis VC, et al. An in vivo cinefluoroscopic study of subjects without cervical abnormality, Anaesthesiology 1996; 85:26–36.
  2. Horton WA, Fahy L, Charters P. Disposition of the cervical vertebrae, atlanto-axial joint, hyoid and mandible during x-ray laryngoscopy. Br J Anaesth 1989; 63:435–8.
  3. Dooney N, Dagal A. Anaesthetic concerns in acute spinal trauma. Int J Crit Illn Inj Sci 2011; 1:36–43
  4. Robitaille A. Airway Management in the Patient with Cervical Spine Instability. Anaesthesiology Rounds 2008; 7(3); Issue 3
  5. Rao BK, Singh VK, Ray S, Mehra M. Airway management in trauma. Ind J Crit Care Med 2004; 8:98-105.
  6. Nolan JP, Wilson ME. Orotracheal intubation in patients with potential cervical spine injuries. An indication for the gum elastic bougie. Anaesthesia 1993; 48:630–3.
  7. Thiboutot F, Nicole PC, Trépanier CA, Turgeon AF, Lessard MR–Effect of manual inline stabilization of the cervical spine in adults on the rate of difficult orotracheal intubation by direct laryngoscopy: a randomized controlled trial. Can J Anesth. 2009; 56:412–8.
  8. Turkstra TP, Craen RA, Pelz DM, Gelb AW. Cervical spine motion: a fluoroscopic comparison during intubation with lighted stylet, GlideScope, and Macintosh laryngoscope. Anesth Analg 2005; 101:910-5.
  9. McElwain J, Malik MA, Harte BH, Flynn NH, Laffey JG. Determination of the optimal stylet strategy for the C-MA videolaryngoscope. Anaesthesia 2010; 65:369-78.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.