A Comparison of the Effectiveness of the McCoy Laryngoscope and the C-MAC D-Blade Video Laryngoscope in Obese Patients
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Grade | Description |
---|---|
I | Ventilated using a mask |
II | Ventilated using a mask with oral airway |
III | Difficult mask ventilation (inadequate, unstable, or requiring two practitioners) |
IV | Mask ventilation could not be achieved |
Parameter | Scores | Rules for Calculating IDS Score |
---|---|---|
Number of attempts | N1 | N1: Each additional attempt adds 1 pt. |
Number of operators | N2 | N2: Each additional operator adds 1 pt. |
Number of alternative techniques | N3 | N3: Each alternative technique adds 1 pt. (e.g., patient repositioning or change in materials used) |
Cormack grade 1 | N4 | N4: Apply Cormack grade for the first oral attempt. |
Lifting force required | ||
Normal/increased | N5 = 0/N5 = 1 | |
Laryngeal pressure | ||
Not applied/applied | N6 = 0/N6 = 1 | |
Vocal cord mobility | ||
Abduction/adduction | N7 = 0/N7 = 1 | |
Total IDS = Sum of scores | N1–N7 | |
IDS score | Degree of difficulty | |
0 | Easy | |
0 < IDS ≤ 5 | Slight | |
5 < IDS | Moderate to major |
Characteristics | Laryngoscope | p-Value | |
---|---|---|---|
McCoy Group (n = 51) | C-MAC Group (n = 51) | ||
Age (years) | 43.76 ± 12.94 | 39.90 ± 10.87 | 0.103 |
Sex (M/F) (n) | 19/32 | 26/25 | 0.163 |
Mouth opening (cm) | 5 (4.5–5) | 5 (5–5) | 0.080 |
Mallampati classification (n) | |||
I/II/III/IV | 3/26/20/2 | 6/26/16/3 | 0.649 |
Head/neck movement (n) | |||
>90°/90°/<90° | 33/8/10 | 34/5/12 | 0.641 |
Ability to prognath (n) | |||
Yes/partial/no | 42/9/0 | 44/6/1 | 0.439 |
Weight (kg) | 102.24 ± 14.76 | 107.21 ± 15.64 | 0.101 |
Thyromental distance (cm) | 8 (7–9) | 9 (8–10) | 0.083 |
Body mass index (kg/m2) | 36.75 (35.5–39.75) | 36.53 (35.6–38.87) | 0.878 |
History of difficult intubation (n) | |||
None/questionable/definite | 26/25/0 | 17/34/0 | 0.071 |
Neck circumference (cm) | 45.59 ± 4.51 | 46.02 ± 4.43 | 0.627 |
ASA class (II/III) (n) | 42/9 | 41/10 | 0.799 |
Laryngoscope | |||
---|---|---|---|
Outcomes | McCoy Group (n = 51) | C-MAC Group (n = 51) | p-Value |
Mask ventilation | 0.070 | ||
I/II/III/IV | 33/15/3/0 | 27/13/11/0 | |
Vocal cord exposure time (s) | 5.85 (4.81–8.10) | 4.14 (3.47–5.52) | <0.001 * |
Vocal cord passage time (s) | 10.76 (8.75–14.39) | 10.33 (9.21–14.35) | 0.756 |
Intubation time (s) | 32.54 (29.70–37.21) | 30.72 (28.12–32.19) | 0.499 |
POGO score (%) | 70 (50–80) | 70 (50–90) | 0.529 |
IDS | 2 (1–3) | 1 (0–2) | 0.046 * |
Teeth or lip trauma (n) | 0 | 2 | 0.153 |
Laryngoscope | |||
---|---|---|---|
Outcomes | McCoy Group (n = 51) | C-MAC Group (n = 51) | p-Value |
Number of attempts (1/2) | 49/2 | 51/0 | 0.495 |
Number of operators (1/2) | 50/1 | 51/0 | 0.315 |
Number of alternative techniques | 0 | 0 | NA |
Cormack grade | |||
I/II/III/IV | 12/33/5/1 | 19/30/2/0 | 0.260 |
I,II/III,IV | 45/6 | 49/2 | 0.269 |
Lifting force required | |||
Normal/increased | 35/16 | 24/27 | 0.027 * |
Laryngeal pressure | |||
Not applied/applied | 15/36 | 11/40 | 0.363 |
Vocal cord mobility | |||
Abduction/adduction | 51/0 | 51/0 | NA |
Variables | Group | Anesthesia Time | p-Value | |||
---|---|---|---|---|---|---|
Before Induction | Immediately before Intubation | Immediately after Intubation | 3 Min after Intubation | |||
MAP (mmHg) | McCoy | 110.96 ± 13.82 | 76.96 ± 11.24 | 105.20 ± 22.40 | 82.12 ± 14.23 | 0.042 * |
C-MAC | 105.78 ± 19.43 | 76.02 ± 9.48 | 95.02 ± 16.79 | 78.31 ± 11.43 | ||
HR (beats/min) | McCoy | 79.92 ± 17.93 | 76.35 ± 15.81 | 88.90 ± 12.73 | 82.14 ± 12.66 | 0.974 |
C-MAC | 77.92 ± 13.89 | 75.82 ± 15.06 | 87.88 ± 14.62 | 81.43 ± 12.93 | ||
SpO2 (%) | McCoy | 97 (96–98) | 100 (99–100) | 99 (99–100) | 98 (97–99) | 0.775 |
C-MAC | 97 (96–98) | 99 (99–100) | 99 (98–100) | 98 (98–99) |
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Lee, J.-M.; Lee, S.-K.; Jang, M.; Oh, M.; Park, E.-Y. A Comparison of the Effectiveness of the McCoy Laryngoscope and the C-MAC D-Blade Video Laryngoscope in Obese Patients. Medicina 2024, 60, 1285. https://doi.org/10.3390/medicina60081285
Lee J-M, Lee S-K, Jang M, Oh M, Park E-Y. A Comparison of the Effectiveness of the McCoy Laryngoscope and the C-MAC D-Blade Video Laryngoscope in Obese Patients. Medicina. 2024; 60(8):1285. https://doi.org/10.3390/medicina60081285
Chicago/Turabian StyleLee, Jung-Min, Soo-Kyung Lee, Minsoo Jang, Minho Oh, and Eun-Young Park. 2024. "A Comparison of the Effectiveness of the McCoy Laryngoscope and the C-MAC D-Blade Video Laryngoscope in Obese Patients" Medicina 60, no. 8: 1285. https://doi.org/10.3390/medicina60081285