Comparison Between McCoy Laryngoscope and C-MAC Video Laryngoscope in Anticipated Difficult Airway: A Prospective Randomised Study

Objective: Prolonged laryngoscopy and failure to intubate are associated with increased morbidity and mortality. Need to improve glottic visualisation and ease of intubation has led to the introduction of various types of laryngoscopes. This study compares the effectiveness of C-MAC video laryngoscope (VL) with McCoy laryngoscope in patients with an anticipated difficult airway.

Methods: This prospective randomised single-blinded single-centre study included patients with modified Mallampati grades 3 and 4, divided into two groups I and II of 65 patients each. Group I was intubated using C-MAC and group II with McCoy Laryngoscope. Modified Cormack Lehane grade of visualisation, time to intubate, intubation difficulty scale score and complications were recorded.

Results: C-MAC VL provides a higher proportion of modified Cormack Lehane grade I visualisation (63% vs 35.3, p=0.0017), the lesser median time of intubation in seconds (15 vs 18, p=0.0007) and significantly lesser median intubation difficulty score (0 vs 3) when compared to McCoy.

Conclusions: C-MAC VL provided better visualisation of glottis and easier tracheal intubation that too in a significantly lesser time. We conclude and recommend the use of C-MAC VL over McCoy for endotracheal intubation in patients with predicted difficult airways, especially in modified Mallampati grades 3 and 4.