Ease of Intubation with C-MAC Videolaryngoscope: Use of 60° Angled Styletted Endotracheal Tube versus Intubation over Bougie

BACKGROUND: Although videolaryngoscopes improve glottic visualization, their actual usefulness in intubation is not yet established. AIMS: The primary objective was to compare the ease of oral intubation with the use of 60° angled styletted endotracheal tube versus that performed over bougie inserted under videolaryngoscopic guidance. The secondary objectives were assessment of incidence of airway loss, hemodynamic changes, and time and number of attempts at intubation. SETTINGS AND DESIGN: This prospective randomized study was conducted in a tertiary care institution. PATIENTS AND METHODS: Seventy surgical patients requiring oral intubation were randomly allotted to Group S or Group B. Laryngoscopy was performed with Storz(®) C-MAC videolaryngoscope using D-Blade. In Group S, patients were intubated with a 60° angled stylletted endotracheal tube. In Group B, a bougie was introduced into the trachea and endotracheal tube was railroaded over the bougie. STATISTICAL ANALYSIS USED: Chi-square test and independent sample t-test were used as applicable. RESULTS: The ease of intubation was significantly more in patients of Group S as compared to Group B (88.6% vs. 25.7%, respectively, P < 0.001) with significantly shorter intubation time (16.97 ± 7.91 vs. 77.43 ± 35.55 s, respectively, P < 0.001). The requirement of more than one attempt at intubation was significantly higher in Group B [57.1% vs. 5.7% P < 0.001, respectively]. Group B showed a significantly high mean arterial pressure at 1 and 3 min following intubation with no significant change in heart rate. CONCLUSION: Use of 60° angled styletted endotracheal tube resulted in easier and faster intubation as compared to intubation over a bougie when used with C-MAC videolaryngoscope.