Kamil TOKER, Hadi Ufuk YÖRÜKOĞLU, Volkan ALPARSLAN, Alparslan KUŞ, Can AKSU

A comparison of angled (D-Blade) and Macintosh (C-MAC) videolaryngoscopes for simulated pediatric difficult airway: a randomized single-blind study

Background/aim: Being prepared for difficult airway (DA) is nevertheless of great importance. Failed or delayed tracheal intubation (TI) can increase morbidity and mortality, and the pediatric population is more prone to hypoxia. With the development of different types of videolaryngoscope (VL), these have become the device of choice in patients with DA. Our primary aim was to compare intubation times with D-blade and Macintosh blade of Storz C-MAC® in a simulated pediatric DA scenario with this randomized controlled trial. Materials and methods: Children aged 1-5 years scheduled for elective surgery were included in the study. Patients were randomized into two groups: the D-Blade (n = 20) and MAC (n = 21) groups. All children underwent inhalational induction, and a neuromuscular relaxant was routinely administered (rocuronium 0.6 mg.kg-1). After the appropriate size of semirigid foam neck collar had been positioned around the patient’s neck, the D-Blade group patients were intubated using a size 2 D-Blade, and the MAC group patients used a size 2 VL Macintosh blade. Intubation, time was measured. Patients’ modified Cormack-Lehane system scores (MCLS), pre and postintubation blood pressure values and heart rates, and complications during intubation were recorded. Results: Demographic data were similar between the groups. There were also no significant differences in pre and postintubation heart rates, blood pressure, or SpO2 values (p > 0.05 for all). Mean intubation times for the MAC and D-Blade groups were 12.14 ± 2.79 s and 18.31 ± 10.86 s, respectively (p = 0.022). MCLS scores were lower in the D-Blade group (p = 0.030). Intubation success rates were 100% in the MAC group and 90% in the D-Blade group, although the difference was statistically insignificant (p = 0.165). Conclusion: A better laryngoscopic view was obtained with D-Blade. However, the Storz® C-Mac videolaryngoscope Macintosh blade was superior to the D-Blade in achieving a shorter time for TI.

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