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Research article

Simulated Difficult Airway: CMAC D Blade or Glidescope?


Mahesh Madhugiri Chandrashekaraiah ,

King Hamad University Hospital, BH
About Mahesh Madhugiri
Senior Registrar
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Vijay Arjandas Sahitya,

King Hamad University Hospital, BH
About Vijay Arjandas
Senior Registrar
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Priti Narayan,

King Hamad University Hospital, BH
About Priti
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Shahid Adeel

King Hamad University Hospital, BH
About Shahid
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Manual in line axial stabilization (MIAS) technique is recommended for stabilizing the cervical spine in suspected cervical spine injuries, but creates special challenges in airway management. The present study compares two different video laryngoscope (VL) namely CMAC D blade (CMAC) and glidescope blade 4 (GL) for intubation in patients with a simulated difficult airway by applying MIAS.



This was a hospital based prospective, single blind, randomized comparative pilot study. A total of 60 patients, having no predictors of difficult airway and scheduled for elective surgery were recruited and randomized into 2 equal sized groups based on a software generated random sequence. The Primary outcome was Intubation Difficulty Score (IDS), whereas the time taken to secure the airway and obtain a capnographic wave, Cormack Lehane Grade (CL) and hemodynamic parameter comprised the secondary outcomes. The following tests- Fischer’s exact test, Chi-square test and Student ‘t’ test used for analysis.



GL group had an IDS score of zero in 46.7% patients compared to 26.7% in CMAC group, IDS score of 0-5 was found to be 50 % in GL group while CMAC group scored 66.6%. This was found to be statistically insignificant (p=0.18). Time taken for successful intubation was 43.70±9.91 and 54.60±20.47 seconds (p=0.011) in GL and CMAC group respectively.



VL is a vital tool in the management of difficult airway. The superiority of one over the other device tested here could not be established, although GL showed slightly better scores but were statistically insignificant.
How to Cite: Chandrashekaraiah, M.M., Sahitya, V.A., Narayan, P. and Adeel, S., 2021. Simulated Difficult Airway: CMAC D Blade or Glidescope?. Sri Lankan Journal of Anaesthesiology, 29(1), pp.7–12. DOI:
Published on 28 Apr 2021.
Peer Reviewed


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