A Comparative Study of Intubation Parameters between Blockbuster™ Laryngeal Mask Airway and C-MAC™ Video Laryngoscope in Patient with Normal Airway Undergoing Elective Surgery: A Randomised Controlled Trial

Abstract Background and Aims: Management of the airway is the foremost crucial and integral part for an anaesthetist while handling the patient under general anaesthesia. With the advancement of the newer airway equipment, it has made it easy and quick to learn, compatible with patients and decreased the workload of the anaesthetist with reduced complications. Blockbuster™ laryngeal mask airway (BBLMA) is a newer supraglottic equipment, and its efficacy with other techniques has not been much studied. This study was conducted with the aim of comparing the ease and success of endotracheal intubation using blockbuster LMA and the Karl Storz macintosh airway camera videolaryngoscope (C-MAC™ videolaryngoscope) (CMVL) in patients undergoing elective surgery under general anaesthesia. Patients and Methods: This is a single-centred randomised controlled trial which was done in the operation theatre of our institute (All India Institute of Medical Sciences, Patna, India) from 21 st August 2021 to 30 th June 2022. Two hundred and four participants, age group of 18–55 years with the American Society of Anaesthesiologists physical status and modified Mallampati (MMP) Grade I and II planned for elective surgeries under general anaesthesia were enrolled after randomisation. After giving general anaesthesia, intubation was performed either with CMVL (under direct vision) or BBLMA (blind intubation). The primary objectives were to estimate the ease and success of intubation through blockbuster LMA and C-MAC VL. The secondary objectives were to evaluate the number of attempts taken and time taken for successful intubation, intubation success rate in one attempt and overall intubation success rate and to observe any post-operative complications after extubation from either device. Results: The ease of insertion of the endotracheal tube was found to be easy in both groups ( P = 0.447). The overall success of intubation was 100% with CMVL and 97% with blockbuster LMA. The median time of intubation by BBLMA was 17 s, whereas with VL, it was 22 s, and the result was found to be significant ( P = 0.001). The first attempt of successful intubation was 95.1% and 92.2% in Group A and Group B, respectively ( P = 0.322). Conclusions: We conclude that blind intubation with BBLMA is almost comparable to CMVL for intubation in patients with MMP Grades I and II.