Indirect videolaryngoscopy with C-MAC D-Blade and GlideScope: a randomized, controlled comparison in patients with suspected difficult airways

Minerva Anestesiol. 2013 Feb;79(2):121-9. Epub 2012 Oct 2.


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.

Conclusion: 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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Airway Management / instrumentation*
  • Airway Management / methods*
  • Female
  • Glottis / anatomy & histology
  • Humans
  • Intubation, Intratracheal / instrumentation*
  • Intubation, Intratracheal / methods*
  • Laryngoscopes*
  • Laryngoscopy / instrumentation*
  • Male
  • Middle Aged
  • Otorhinolaryngologic Surgical Procedures / instrumentation
  • Video Recording