Intubation with different angles of the intubation tube using C-MACR D-BLEYD videolaringoscop; Evaluation of the effect on intubation success, subglotic damage, and postoperative throat pain: A prospective randomized study

SUMMARY Providing the safety of the patient's airway is every anestheisologist primary concern. Especially in patients with airway difficulty C-MAC R videolaryngoscope D- blade has proven itself to be useful with its 80 degree of camera angle. In this study we compared the intubation success, time needed for intubation, subglottic damage, postoperaitve sore throat, hoarseness and hemodynamic response to orotracheal intubation using three different intubation stylets with C-MAC R videolaryngoscope D- blade. After the approval of the Ethics Committee, patients were randomized into three groups with closed envelope technique. In Group A endotracheal tube (ETT) is shaped into an angel of 90 degrees, in Group B 80 degrees and in Group C 60 degrees with three different stylets. Laryngoscopy was performed using D-Blade in all 3 groups. Heart rate and blood pressure before and after intubation, time from the entrance of the laryngoscope into the mouth to the passage of the vocal cords, time from the appearance of the cords to intubation, Cormack-Lehane (C-L) classification were recorded. Subglottic damage was examined with fiberoptic bronchoscope. Patients were evaluated regarding postoperative sore throat and hoarsness at 30 minutes, 4, 12, 24 hours postoperatively. In our study we found no statistically important difference between groups regarding subglottic damage. It was shown that the time required for intubation was shortest in Group C and longest in Group A. Patients in Group B had the greatest postoperative sore throat incidence and severity. According to intubation difficulty scores, Group C is less likely to be difficult but an increase in hemodynamic response to intubation was most severe in this group. Key Words: Videolaryngoscope, Intubation, C-MAC R Videolaryngoscope, D- Blade, Subglottic damage, Postoperative sore throat, hoarsness