title: Indirect videolaryngoscopy with C-MAC D-Blade and GlideScope: a randomized, controlled comparison in patients with suspected difficult airways.
abstract: BACKGROUND
  Recently, indirect videolaryngoscopes have become increasingly important devices in difficult airway management. The aim of the present study was to investigate laryngoscopic view and intubation success using the new C-MAC® D-Blade in comparison to the established GlideScope® videolaryngoscope and conventional direct laryngoscopy in a randomized controlled trial.
  
  
  METHODS
  Ninety-six adult patients with expected difficult airways undergoing elective ear, nose and throat surgery (ENT) requiring general anesthesia were investigated. Repeated laryngoscopy was performed using a conventional direct Macintosh laryngoscope (DL), C-MAC D-Blade (DB) and GlideScope (GS) in a randomized sequence before patients were intubated with the last device used.
  
  
  RESULTS
  Both videolaryngoscopes showed significantly better C/L (Cormack-Lehane) classes than DL. Insufficient laryngoscopic view, defined as C/L ≥ III, was experienced in 18 patients (19.2%) with DL, in two patients with GS (2.1%) and in none with DB (0%). Time to best achievable laryngoscopic view did not differ between devices. Intubation time was significantly longer with both videolaryngoscopes (Median [Range] DB: 18 [8-33] s, and GS: 19 [9-34] s) than with DL (11 [5-26] s). However, intubation success was 100% for both DB and GS, whereas four patients could not be intubated using conventional direct laryngoscopy.
  
  
  CONCLUSIONS
  Compared to direct Macintosh laryngoscopy, both C-MAC® D-Blade and GlideScope® comparably resulted in an improved view of the glottic opening with successful tracheal intubation in all patients.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University-Hospital Schleswig-Holstein UKSH, Campus Kiel, Kiel, Germany. serocki@anaesthesie.uni-kiel.de
authors.forename: G
authors.initials: G
authors.lastname: Serocki
authors.forename: T
authors.initials: T
authors.lastname: Neumann
authors.forename: E
authors.initials: E
authors.lastname: Scharf
authors.forename: V
authors.initials: V
authors.lastname: Dörges
authors.forename: E
authors.initials: E
authors.lastname: Cavus
mesh_terms: D000328:Adult; D000368:Aged; D058109:Airway Management / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005931:Glottis / Q000033:anatomy & histology; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods*; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000295:instrumentation; D014741:Video Recording