الفهرس 
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Abstract
Numerous indirect laryngoscopes have been introduced into clinical practice and compared with the Macintosh laryngoscope. Most studies have described a significantly better glottic view and a higher success rate in difficult tracheal intubations for the indirect laryngoscopes. Some case reports also describe the successful use of these tools under sedation with preserved spontaneous breathing.
Videolaryngoscopes with the Macintosh blades can offer the unique benefit of both direct and indirect laryngoscopy in a single intubation attempt. A typical example of such a device is C-MAC videolaryngoscope, which is the first Macintosh-type videolaryngoscope, with a great number of publications.
This study was designed to compare between the C-MAC® D-Blade video laryngoscope and the flexible fiberoptic scope (FFS) for intubation of patients with anticipated difficult intubation.
The aim of this study was to compare the C-MAC® D-Blade video laryngoscope and the flexible fiberoptic scope for intubation of patients with anticipated difficult intubation. The primary endpoint was the time to achieve successful tracheal intubation. Secondary endpoints included glottic view at intubation and the number of intubation attempts. The study was conducted on 60 patients at the operating theatres of Ain Shams University Hospitals.
After obtaining approval from the Research Ethical Committee, Faculty of Medicine, Ain Shams University and informed consents from patients, 60 American Society of Anaesthesiologists I-II adult patients with El-Ganzouri risk index score (EGRI) ≥ 4 (age range, 21-60 years) undergoing elective surgeries requiring tracheal intubation were enrolled in this prospective study at the operating theaters of Ain Shams University Hospitals from March 2022 to October 2022. The exclusion criteria included patients at increased risk for aspiration (eg, full stomach, gastroesophageal reflux disease or pregnancy), patients who required an awake fiberoptic intubation or emergency surgery, patients with expected difficult ventilation, patients with cardiac and/or respiratory disease, patients who had an upper airway pathology and patients with a mouth opening < 2 cm. Patients who met all inclusionary criteria were assigned to 1 of 2 treatment groups according to a computer-generated random numbers table: (1) Storz C-MAC video laryngoscope group (VL; n = 30) and (2) The Flexible Fiberoptic Scope group (FO; n = 30).
Our results showed Duration of intubation (s) among the study groups. Duration of intubation (s) in Video laryngoscope group ranged from 22 to 34 seconds with mean ± SD = 27.87 ± 3.74 while in Fiberoptic group the Duration of intubation (s) ranged from 60 to 75 seconds with mean ± SD = 66.77 ± 4.24 with highly statistically significant difference (p= <.001) between the two groups.
Our results showed POGO score among the study groups. Regarding POGO score, there was a significant difference between the two studied groups (p= 0.019).
Our results showed End-tidal CO2 1 min after intubation among the study groups. End-tidal CO2 1 min after intubation was significantly higher in the (FO) group compared to the (VL) group (P < 0.001).
Other results were all statistically insignificant between the two groups.
C-MAC video laryngoscope had become a good alternative and was associated with visualization of laryngeal structures in shorter time as compared to traditional flexible fiberoptic laryngoscopy.