Impact of different tube angles on intubation outcomes with C-MACR D-blade videolaryngoscope: A prospective randomized study
Trends in Anaesthesia and Critical Care, cilt.65, 2025 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 65
- Basım Tarihi: 2025
- Doi Numarası: 10.1016/j.tacc.2025.101594
- Dergi Adı: Trends in Anaesthesia and Critical Care
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE
- Anahtar Kelimeler: Postoperative sore throat, Hoarseness, Subglottic damage, C-MAC videolaryngoscope, D-blade, 60(degrees), 80(degrees), 90(degrees )angled endotracheal tube
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: The C-MACR D-blade videolaryngoscope provides better visualization of vocal cords via the blade angle, however, stylet is required. This study compares postoperative sore throat (POST), hoarseness, intubation period and ease, subglottic damage (SGD), and hemodynamic changes to orotracheal intubation using different angled (60°-80°-90°) endotracheal tubes (ETT) with C-MACR D-blade videolaryngoscope. Methods: After Ethics Committee approval and consents taken, study was conducted in Yeditepe University Medical Faculty between June and December 2022. This prospective study involved 162 patients; who were planned to undergo general anesthesia with ASA score I-II (18–65years), randomized into three groups with closed envelope technique. In Group A ETT is bent into 90°, Group B 80° and Group C 60° using stylets. C-MACR D-blade videolaryngoscope was used. Hemodynamic data, intubation period and ease were recorded. SGD was examined with fiberoptic bronchoscope. Patients were evaluated regarding POST and hoarseness at 30 min, 4, 12, and 24 h postoperatively. Results: Study showed intubation period was longest in Group A and shortest in Group C (p < 0.001). Group B had more POST incidence at 30 min (p = 0.040) and had the highest POST incidence in total 24 h (p = 0.040). There were no difference regarding SGD (p = 0.300) and hoarseness (30th minute p:0.610, 4th hour p:0.350, 12th hour p:0.130 and 24th hour p:0.130). In Group C intubations were easiest according to modified intubation difficulty scale (p = 0,020) however, hemodynamic response was highest (p < 0.001). Conclusion: We recommend using 60° angled ETTs in rapid sequence intubations. However, we do not recommend it in the population with low tolerance for hemodynamic instability. Clinical trials registration number: NCT06011967.