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ORIGINAL ARTICLE   Free accessfree

Minerva Anestesiologica 2021 August;87(8):873-9

DOI: 10.23736/S0375-9393.21.15302-7


language: English

Prospective observational study evaluating the C-MAC Video Stylet for awake tracheal intubation: a single-center study

Sabine NABECKER 1, 2 , Thora OTTENHAUSEN 1, Lorenz THEILER 3, Matthias BRAUN 1, Robert GREIF 4, Thomas RIVA 1

1 Department of Anesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland; 2 Department of Anesthesia and Pain Management, Sinai Health System, University of Toronto, Toronto, ON, Canada; 3 Department of Anesthesia, Kantonsspital Aarau, Aarau, Switzerland; 4 School of Medicine, Sigmund Freud University Vienna, Vienna, Austria

BACKGROUND: The gold standard for management of known or predicted difficult airways is awake tracheal intubation. The newly developed C-MAC Video Stylet promises to combine the advantages of rigid stylets and flexible optical scopes. We therefore evaluated the feasibility of awake orotracheal intubations with this device.
METHODS: In this prospective observational study, three anesthesiologists experienced in advanced airway management performed each 12 awake oral intubations with this device on adult patients with known or predicted intubation difficulties. The primary outcome was overall intubation success. Secondary outcomes were total attempts, successful time, first postoperative day sequelae, and subjective intubation difficulty rated on a visual analogue scale (1, very easy; 10, extremely difficult).
RESULTS: Thirty-six patients (10 females), aged 64±13 years, with BMI 26±5 kg/m2, were enrolled in the study. ASA status II, III, IV were eight (22%), 23 (64%), and five (14%), respectively. Indications for awake oral intubation were: oropharyngeal tumor 20 (56%), cervical-spine fracture eight (22%), previously known difficult airway four (11%), spinal canal stenosis three (8%), and bilateral peritonsillar abscess one (3%). Overall, 97% were successfully intubated in 45 s (31-88). First-attempt success rate was 80% in 37 s (29-54); 92% of patients would choose the same procedure again. On the first postoperative day, 11 (31%) patients complained of sore throat; five (14%) had minor injuries. Ease of intubation was rated as median VAS 3 (IQR: 1-7).
CONCLUSIONS: The new C-MAC Video Stylet has the potential to serve as a suitable device for visualized oral awake intubation in difficult airway situations.

KEY WORDS: Airway management; Intubation; Equipment and supplies

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