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Randomized Controlled Trial
. 2024 Aug 9;60(8):1285.
doi: 10.3390/medicina60081285.

A Comparison of the Effectiveness of the McCoy Laryngoscope and the C-MAC D-Blade Video Laryngoscope in Obese Patients

Jung-Min Lee  1 , Soo-Kyung Lee  2 , Minsoo Jang  2 , Minho Oh  2 , Eun-Young Park  2
Affiliations
Randomized Controlled Trial

A Comparison of the Effectiveness of the McCoy Laryngoscope and the C-MAC D-Blade Video Laryngoscope in Obese Patients

Jung-Min Lee et al. Medicina (Kaunas). .

Abstract

Background and Objective: Obesity is associated with difficult or failed intubation attempts, making general anesthesia challenging for anesthesiologists to perform. The purpose of this study was to evaluate and compare the efficacy of a McCoy laryngoscope and a C-MAC D-blade video laryngoscope for intubation in obese patients with a body mass index (BMI) ≥ 35 kg/m2. Methods: In total, 104 patients were randomly assigned to be intubated with a McCoy (McCoy group) or C-MAC D-blade video laryngoscope (C-MAC group). The primary outcome was intubation time. The secondary outcomes were vocal cord exposure time, vocal cord passage time, proportion of successful intubation, mask ventilation scale, intubation difficulty scale (IDS), percentage of glottis opening (POGO) score, and hemodynamic variables. Results: Although the intubation time did not significantly differ, the C-MAC group showed shorter vocal cord exposure times and a higher rate of successful vocal cord exposure within 5 s. The IDS value was significantly lower in the C-MAC group than in the McCoy group. The proportion of patients who required an increase in lifting force during laryngoscopy was higher in the McCoy group than in the C-MAC group, which may explain the difference in MAP between the groups. Conclusions: Both the McCoy laryngoscope and the C-MAC D-blade video laryngoscope were useful during the intubation of obese patients. The C-MAC D-blade video laryngoscope might be more useful for obese patients in terms of hemodynamic stability.

Keywords: airway management; general anesthesia; intratracheal intubation; laryngoscopy; obesity.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
CONSORT flow chart.
Figure 2
Figure 2
Cumulative proportions of adequate vocal cord exposure with McCoy laryngoscope and C-MAC D-blade video laryngoscope.
Figure 3
Figure 3
Changes in MAP over time in each group. Data are shown as mean ± standard deviation. MAP, mean arterial pressure. * p = 0.011 for McCoy vs. C-MAC at the same time point.
See this image and copyright information in PMC

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