A randomised comparative study of “videoendoscope” with the Truview EVO2, C-MAC D blade videolaryngoscope and the Macintosh laryngoscope

Abstract

Background and Aims:

Videolaryngoscopes are crucial components of a difficult airway cart. Issues of cost and availability, however, remain a problem. We compared the combination of an endoscope used in conjunction with the Macintosh laryngoscope with established videolaryngoscopes and the Macintosh laryngoscope using the intubation difficulty scale (IDS) score.

Materials and Methods:

A prospective randomised study including 120 adult patients, American Society of Anaesthesiologists (ASA) physical status I–III, with an anticipated difficult airway scheduled for elective surgery were randomly allocated to one of four groups: Truview EVO2 (group 1), C-MAC D Blade (group 2), videoendoscope (group 3), or Macintosh laryngoscope (group 4). The IDS score was the primary outcome. Secondary outcomes included the Cormack–Lehane grade, time to tracheal intubation, haemodynamic responses, and adverse events.

Results:

A significant proportion of patients in groups 2 and 3 had an IDS score of zero (73.3 and 70%, respectively). IDS scores were significantly lower in the C-MAC D blade and videoendoscope groups attributable to differences in parameters N4, N5 and N6 [C/L grades, lifting force and laryngeal pressure required] ( P < 0.001). The C-MAC D blade and the Macintosh laryngoscope required less time for intubation as compared to the Truview EVO2 and videoendoscope. No differences were noted in post-intubation haemodynamic parameters and other adverse events.

Conclusion:

The performance of videoendoscope was comparable to C-MAC D Blade and superior to Truview EVO2 and Macintosh laryngoscope with respect to the IDS score and may thereby provide an effective alternative to commercial videolaryngoscopes in low resource settings.