Study to compare the efficacy of C-MAC video laryngoscope with conventional direct laryngoscope using miller's blade 0 for neonatal intubation at tertiary care hospital

Abstract

Airway management in neonates is a major challenge for pediatric anesthesiologists. Neonates allow a very short apnea time during induction of anesthesia; therefore, intubation should be quickly achieved within this narrow safety period. Present study was aimed to
compare the efficacy of C-MAC video laryngoscope with conventional direct laryngoscope using miller's blade 0 for neonatal intubation at tertiary care hospital. Material and Methods: Present study was single-center, prospective, comparative study, conducted in term/ Late preterm neonates, weighing more than 1500 gms, undergoing elective and emergency surgeries. Neonates were randomized into two groups (45 in each group) as Group C-MAC & Group DL. Results: In present study, mean postnatal age, Gender-wise distribution, mean gestational age & mean birth weight in both groups was comparable. Mean duration of successful laryngoscopy with C-MAC was (16.6 ± 4.85 sec) less than direct laryngoscope (28.11 ± 6.82 sec), difference was statistically significant (P-value: <0.0001). Majority neonates in group C-MAC showed CL grade I, and grade II (35.56% each), whereas in group DL, majority neonates showed CL grade I (75.56%), difference was statistically significant (P-value: <0.0001). Laryngoscopy in the first attempt was successful in 93.33% of neonates using C-MAC VL whereas using DL, the laryngoscopy was successful in the first attempt in 66.67% of neonates. difference was statistically significant (P-value: 0.016). Majority neonates were intubated in the first attempt in group C-MAC (90.11%) as compared to group DL (64.4%), difference was statistically significant (P-value: 0.009). The adverse events like bradycardia episodes, oesophageal intubations, gastric distention were more with group DL as compared to group C-MAC, though it is not statistically significant (p-value: >0.05)
Conclusion: C-MAC video laryngoscope is found to be superior to Conventional Direct Laryngoscope for neonatal intubation in terms of lesser intubation time, the higher firstattempt success rate.