The performance of C-MAC videostylet versus D-Blade during tracheal intubation in patients with simulated cervical immobilization: A randomized comparative trial

ABSTRACT

Background

Concerning patients with suspected cervical spine (C-spine) fractures or other cervical pathologies, tracheal intubation must be done very carefully to avoid injury to the spinal cord.

Methods

Fifty-two patients within a range of 20–60 years old, and arranged for elective surgery, were indiscriminately allocated into two groups; Group S was intubated with the C MAC Videostylet (VS), whereas Group L was intubated by D blade Video Laryngoscope (VL) during cervical immobilization by Philadelphia collar. The first successful attempt duration, total number of intubation attempts, the total duration of the intubation, haemodynamic parameters, stress response of intubation, the degree of C-spine movement and complications were evaluated in both groups.

Results

Group L showed substantially shorter times for the first successful attempt (p-value <0.001) and the whole intubation procedure (p-value <0.001) compared to Group S. Group S had a significantly more total number of intubation attempts (p-value = 0.010). The haemodynamic parameters did not significantly differ throughout the measurements among groups. Regarding the blood cortisol measurements at different periods, there were statistically insignificant changes among the groups. Concerning the greatest alteration in C-spine angulation at the occiput-C1, C1-C2, and C2-C5 segments during laryngoscopy and intubation, there were statistically insignificant differences among groups.

Conclusion

The C MAC D-blade VL is superior to the VS in terms of the number and duration of intubation attempts during C-spine immobilization. Conversely, the VS showed comparable results to the D blade regarding C-spine motion and stress response.

KEYWORDS:

• Tracheal intubation and cervical spine movement
• cervical spine injury
• cervical immobilization
• video stylet
• D blade video laryngoscope

Acknowledgments

We thank the Medical Research Institute’s radiology department for their cooperation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All related data supporting the study’s findings are incorporated in this article. Additional data can be obtained upon reasonable request from the corresponding author.