The effect of the laryngoscopic view with C-MAC videolaryngoscope size 1 Miller Bleyd lifting the epiglottis or the base of tongue in children younger than two years of age

Background: In our study, we aimed to evaluate the glottic visualization and time to intubation during laryngoscopy performed with the C-MAC VL size 1 Miller blade lifting the epiglottis or placing the tip of the blade on the base of the tongue (vallecula) in children younger than 2 years of age. Materials and Methods: Totally 127 children younger than 2 years of age who were classified ASA I and II patients will undergo elective surgery under general anesthesia with tracheal intubation, was included in the study. Following standard monitoring, fentanyl (1 mcg/kg IV), thiopental (5 mg/kg IV) and inhaled sevoflurane (8%) with oxygen and rocuronium (0.6 mg/kg IV) for neuromuscular blokade were administered for anesthesia induction. The shoulders of all patients were slightly lifted with a towel roll and intubation was performed with an uncuffed spiral ETT with a stylet of the appropriate size for their age. The patients in which the C-MAC VL size 1 Miller blade was placed on the base of the tongue (vallecula) were defined as Group V (n=62) and the patients where it was placed under the epiglottis were defined as Group E (n=65). HR, MAP, SpO2, EtCO2 measurements of the patients were recorded as before induction, after induction, after intubation 1st, 3rd and 5th minutes. POGO, CL, IDS and subjective intubation difficulty scores, times to laryngoscopy and intubation, number of intubation attempts, optimization procedures during ETE and complications were recorded of all patients. Results: Demographic characteristics of the groups were similar but POGO and Cormack-Lehane scores were statistically significant and better in Group E. Time to laryngoscopy and intubation were statistically significant and shorter in Group V. Subjective intubation difficulty score was significantly easier in Group V, and IDS score was similar between groups. The number of intubation attempts and optimization maneuvers, HR, MAP, and SpO2 measurements of the groups were statistically similar. Conclusion: In our study, it was shown that the use of the C-MAC VL size 1 Miller blade in children younger 2 years of age by lifting under the epiglottis improves glottic visualization and prolongs laryngoscopy and intubation times compared to it use by placing on the vallecula. We think that it may be more beneficial to use the C-MAC VL size 1 Miller blade in the vallecula in the airway management of children in this age group who desaturate more rapidly. Keywords: İnfant, intubation, laryngoscopy, glottis.