Comparison of C-MAC ® mac blade videolaryngoscope, C-MAC ® D blade videolaryngoscope and macintosh laryngoscope in double lumen tube patients

Objective: In the intubation procedure of patients who used double lumen tube for one lung ventilation in thoracic surgery; We aimed to compare the C-MAC® D Blade and C-MAC® MAC Blade videoingoscope with the Macintosh Laryngoscope in terms of intubation time, hemodynamic response and complications related to intubation. Materials and Methods: A total of 240 patients between the ages of 18-75 who underwent elective surgery, intubated with a double-lumen tube under general anesthesia in thoracic surgery were included in the study. The patients were divided into 3 groups as Storz C-MAC MAC Blade videoingoscope; MAC Blade VL (n=80), Storz C-MAC D Blade videoingoscope; D Blade VL (n=80) and Macintosh Laryngoscope; DL (n=80). Preoperative airway evaluation, glottic vision and intubation times, Cormack-Lehane score, number of intubation attempts, and tracheobronchial intubation complications of the cases were recorded. Hemodynamic response (KAH, OAB) of the cases were measured before induction, after induction, and at the 1st, 3rd, 5th, and 10th minutes after intubation. Results: The demographic data of the cases were similar, and the best glottic image acquisition time (exposure time) in this study was shorter in the D Blade VL group than in the Mac Blade VL group. Stylet removal time (intubation time 1) in the DL group was longer than in the D Blade VL group. Although it was found that D Blade VL and Mac Blade VL groups shortened the intubation time and decreased the number of maneuvers and attempts compared to DL, no significant difference was found in the malposition rate. In our study, it was also shown that the DL group increased hemodynamic response (OAB) and postoperative sore throat after induction. Conclusion: C-MAC Mac Blade was found similar to C-MAC D Blade in patients who underwent double lumen tube in terms of intubation time, cardiovascular stability, and postoperative complications. We recommend the routine use of C-MAC Mac Blade in order to enable rapid transition to the C-MAC D Blade when we encounter an unexpectedly difficult airway with the C-MAC Mac blade in the application of CLT in cases with normal airway. Keywords: C-MAC® MAC Blade Videolaryngoscope, C-MAC® D Blade Videolaryngoscope, Double lumen tube, One lung ventilation