We aimed at comparing the performance of the conventional C-MAC, D-blade C-MAC and Macintosh laryngoscopes when performing tracheal intubation in patients undergoing neck immobilization using manual inline axial cervical spine stabilization.

Ninety consenting patients presenting for surgery requiring tracheal intubation were randomly assigned to undergo intubation using a conventional C-MAC, D-blade C-MAC or Macintosh laryngoscope. All patients were intubated by single anaesthetist experienced in the use of each laryngoscope

The D-blade C-MAC laryngoscope performed best in these patients, reducing the Intubation Difficulty Scale score, improving the Cormack and Lehaneglottic view, and reducing the need for optimization manoeuvres, compared with both the conventional C-MAC and Macintosh laryngoscopes. Moreover, hemodynamic profile of patients intubated with D-blade C-MAC was better than that of conventional C-MAC and Macintosh laryngoscopes. The conventional C-MAC and Macintosh laryngoscopes performed similarly in terms of success of intubation or post intubation hemodynamics of the patients.

The D-blade C-MAC laryngoscope performed better than the conventional C-MAC and Macintosh laryngoscopes in patients undergoing cervical immobilization.