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Abstract

Background & Aims Of The Study: Direct laryngoscopy requires the movement of the head, neck, and cervical spine. The study aimed to compare the head extension, cervical spine extension & laryngeal view obtained with C-Mac D-Blade & McCoy blade for endotracheal intubation in patients with cervical spine injury.
Methods: In this study, 50 patients with C-Spine injuries posted for surgery were studied and allocated into 2 groups. After induction of general anaesthesia with neuromuscular blockade, tracheal intubation was performed with C-Mac D-Blade & McCoy blade in patients in random order. Cinefluoroscopic images of C-spine movement during intubation were obtained and divided into four stages: a baseline image before airway manipulation, glottic visualization, insertion of the endotracheal tube into the glottis, and tracheal intubation. Peak cervical motion from the occiput to C5 was measured for each patient and each stage, averages were calculated, and movements induced by each instrument were compared using a Chi-square test. Also, the quality of glottic visualization were studied.
Results: Significant reductions in radiographic cervical spine extension were found at C0-C1 & C1-C2 for C-Mac D-Blade compared to McCoy blade with a p < 0.0001. The time taken for tracheal intubation was longer with C-MAC D blade group of fifty-two seconds compared with McCoy blade group which was thirty-six seconds. Good grade glottic visualisation was obtained with both the laryngoscopic blades.
Conclusion: The C-Mac D-Blade caused less head extension & cervical spine extension than McCoy Blade and resulted in a better glottic view but time taken for intubation was longer with C-Mac D-Blade.