Endotracheal Tube Cuff Inflation Technique for Nasotracheal Intubation: A Comparison of C-Mac® D™ Blade and Macintosh Laryngoscopes

Document Type : Original Article

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Department of Anaesthesiology, ESIC Medical College and Post Graduate Institute of Medical Sciences and Research, Basaidarapur, New Delhi.

Abstract

Objective: Oral and maxillofacial surgeries require Nasotracheal intubation (NTI). While guiding Endotracheal tube (ETT) from oropharynx into glottis, tip requires alignment with glottis for successful intubation. The study compared Macintosh laryngoscope (ML) with C-Mac® D™ blade Videolaryngoscope (VL) utilising ETT cuff inflation technique.
Method: Sixty patients were randomly allocated to two groups: Group D (C-Mac® D™ blade VL) and Group M (ML) and NTI performed using ETT cuff inflation. Primary outcome was to measure total time taken for successful NTI, whereas secondary outcomes included observing total number of attempts, cuff inflation with 15ml air, need for additional 5ml air, use of Magill’s forceps, haemodynamic response, and complications.
Result: Total time taken (sec) for successful intubation was significantly less in groupD (30.43 ± 7.18) as compared to groupM (46.83 ± 14.83), p value <0.0001. All patients in groupD were successfully intubated in one attempt, in groupM 5/30 (16.67%) patients required two attempts (p value 0.052). Successful NTI was achieved with 15ml cuff inflation in 25 (83.33%) patients in groupD and 14 (46.67%) in groupM, p value 0.003. Magill’s forceps were required in 11 (36.67%) patients in groupM, whereas none in groupD required its assistance. Haemodynamic parameters were significantly high at 1,3 and 5mins in groupM. Trauma to oral mucosa was observed in 7/30 (23.33%) patients in groupM whereas none in groupD.
Conclusion: ETT cuff inflation with C-Mac® D™ blade VL requires less time, has better success for NTI, with less haemodynamic response and postoperative complications as compared to ML.

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