Comparison of Split-Type Postman and C-MAC Video Laryngoscopes for Ease of Intubation in Simulated Restricted Neck Mobility: A Randomized Controlled Trial

Endotracheal intubation is critical for securing a patient's airway during emergencies and general anesthesia. This study aims to compare the efficacy of the Split-type Postman and C-MAC video laryngoscopes for intubation under simulated restricted neck mobility, focusing on intubation time, success rates, and hemodynamic responses. This prospective, hospital-based, randomized controlled trial included 50 American Society of Anesthesiologists physical status Classes I and II patients aged 18 to 60 years undergoing elective surgery under general anesthesia. Patients were randomly assigned to be intubated with the Split-type Postman or C-MAC video laryngoscope. The primary objective was to compare intubation times, while the secondary objectives included assessing first-attempt success rates, percentage of glottic opening scores, use of ancillary devices, and hemodynamic responses. The Split-type Postman video laryngoscope demonstrated significantly faster median times for glottis visualization (14.94 vs. 17.49 seconds) and tube placement confirmation (13.07 vs. 18.93 seconds) compared with the C-MAC video laryngoscope (p-value <0.01). Total intubation time was shorter for the Postman group (27.64 vs. 36.69 seconds) with a p-value <0.01. Both groups exhibited comparable hemodynamic stability, with no significant differences in heart rate, systolic, diastolic, or mean arterial pressure at various time points postintubation. The first-attempt success rate with the C-MAC video laryngoscope was comparable (p-value 0.584) with the Split-type Postman video laryngoscope, and it required less frequent use of ancillary devices such as bougie/stylet compared with the Split-type Postman video laryngoscope. The Split-type Postman video laryngoscope offers faster intubation times than the C-MAC video laryngoscope, making it particularly advantageous in emergency situations. Both devices provide comparable hemodynamic stability and first attempt for successful intubation. Further research is recommended to validate these findings across diverse clinical settings. However, the Postman video laryngoscope may require additional tools for successful intubation.