Vol. 7, Issue 2, Part A (2025)

Background & Objectives: Managing the airway is one of the commonest challenges an anesthesiologist encounters in routine practice. Inadequate ventilation, difficult and failed endotracheal intubation may lead to hypoxia resulting in increased adverse respiratory events and worse outcomes in both operative and emergency settings. In recent years, video-laryngoscopes have gained much popularity, including Truview-EVO2 laryngoscope, C-MAC video-laryngoscope, and various other varieties of video-laryngoscope. This study is designed to compare the C-MAC, Truview, and Macintosh laryngoscope for intubation in patients undergoing surgical procedure concerning ease of intubation.

Material & Methods: 228 patients with ASA status I-II were randomly selected and divided into 3 groups, Macintosh (M), Truview (T), C-MAC (C), comprising of 76 patients in each group. Our database compared laryngoscopy and intubation time (seconds), Cormack-Lehane (C-L) score, laryngoscopic maneuvers, complications, and hemodynamics among 3 groups.

Results: The mean laryngoscopy time (seconds) was significantly longer with T group (19.09±2.69) as compared to C (16.18±1.55) and M groups (12.0±1.36). However, C-L grade I was higher in group C as compared to other groups (p<0.001). Requirement of backward-upward-rightward pressure was significantly higher in M group than other groups (p=0.001). Sore throat was present in 3(4.17%), 4(5.56%) and 7(9.72%) patients in C, T and M groups, respectively within 24 hours post-operatively. There was significant rise in heart rate, systolic and diastolic blood pressures at 1-minute post-intubation in group T as compared to other groups from the baseline (p<0.01).

Conclusion: C-MAC video-laryngoscope and Truview-EVO2 provide better glottic visualization and C-L grades with lesser requirement of laryngoscopic maneuvers. However, time to intubation with Truview laryngoscope is prolonged, as tube advancement towards the glottic inlet is comparatively difficult, requiring hand-eye coordination, resulting in significantly higher post-intubation hemodynamic parameters. In sum, these video-laryngoscopes by a well-trained anesthesiologist may be an essential tool for difficult intubation.