What is it about?
Comparision of Direct vs Indirect Laryngoscopic View by C-Mac Videolaryngoscope
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Why is it important?
Introduction: Previous studies have hypothesized that in routine patients undergoing surgery, the conventional C-MAC video laryngoscope compared to direct laryngoscopy can improve the rate of glottis view significantly. The C-MAC platform is to our knowledge the only Video Laryngoscope that allows the clinician to perform both direct and indirect laryngoscopy with the same blade and can be used as its own control. Aim: To compare laryngoscopic view by direct and indirect laryngoscope. Materials and Methods: Following ethical approval and sample size estimates 65 consecutive patients undergoing surgery under general anaesthesia were studied. First direct laryngoscopy was performed using conventional C-MAC and the best view obtained was graded by the first anaesthesiologist without looking at the video monitor. A second anaesthesiologist blinded to the laryngeal view obtained under direct laryngoscopy graded the laryngeal view on the video monitor, this was considered as indirect view. Parameters observed were modified Cormack Lehane grading of which grade 1 and 2a were defined easy views, grade 2b and 3a as restricted views and grade 3b and 4 were graded as difficult views. BURP (Backward Upward Right Pressure) mannevour and intubating aids wereused when required and were noted down. Results and Discussion: Easy views were 20 (30.8%) in direct and 47 (72.3%) in indirect. Restricted views were 41 (63%) in direct and 18 (27.7%) in indirect. Difficult views were 4 (6%) in direct and nil in indirect. These were statistically significant with p value <0.01. Indirect view coincided well with Mallampatti grading than direct view. BURP was applied more in direct view than indirect view. Conclusions: C-MAC by improving laryngoscopic view becomes an important tool in both anticipated and unanticipated difficult airway. It serves as both an innovation for difficult airway management and as a powerful teaching tool.
Perspectives
Introduction: Previous studies have hypothesized that in routine patients undergoing surgery, the conventional C-MAC video laryngoscope compared to direct laryngoscopy can improve the rate of glottis view significantly. The C-MAC platform is to our knowledge the only Video Laryngoscope that allows the clinician to perform both direct and indirect laryngoscopy with the same blade and can be used as its own control. Aim: To compare laryngoscopic view by direct and indirect laryngoscope. Materials and Methods: Following ethical approval and sample size estimates 65 consecutive patients undergoing surgery under general anaesthesia were studied. First direct laryngoscopy was performed using conventional C-MAC and the best view obtained was graded by the first anaesthesiologist without looking at the video monitor. A second anaesthesiologist blinded to the laryngeal view obtained under direct laryngoscopy graded the laryngeal view on the video monitor, this was considered as indirect view. Parameters observed were modified Cormack Lehane grading of which grade 1 and 2a were defined easy views, grade 2b and 3a as restricted views and grade 3b and 4 were graded as difficult views. BURP (Backward Upward Right Pressure) mannevour and intubating aids wereused when required and were noted down. Results and Discussion: Easy views were 20 (30.8%) in direct and 47 (72.3%) in indirect. Restricted views were 41 (63%) in direct and 18 (27.7%) in indirect. Difficult views were 4 (6%) in direct and nil in indirect. These were statistically significant with p value <0.01. Indirect view coincided well with Mallampatti grading than direct view. BURP was applied more in direct view than indirect view. Conclusions: C-MAC by improving laryngoscopic view becomes an important tool in both anticipated and unanticipated difficult airway. It serves as both an innovation for difficult airway management and as a powerful teaching tool.
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This page is a summary of: Comparision of Direct vs Indirect Laryngoscopic View by C-Mac Videolaryngoscope, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6319.14.
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