Trial reportAnnals of African medicine2026
Comparison of the Effect of Left Head Rotation versus the Direct Epiglottis Lifting Technique on Glottic View during C-MAC Videolaryngoscopy in Patients with Difficult Airway.
Trial report in Annals of African medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
BACKGROUND AND
aimsOptimal glottic visualization is fundamental for safe intubation in patients with difficult airways. We aimed to compare the effectiveness of left head rotation (LeHeR) versus the direct epiglottis lifting technique using the C-MAC D-blade videolaryngoscope in improving glottic view during intubation in adult patients with difficult airways.
methodsIn this prospective, randomized, double-blinded trial, 60 adult patients were allocated equally to receive LeHeR (Group L) or direct epiglottis lifting (Group E) technique for intubation. After standardized induction, videolaryngoscopy with C-MAC D blade was done, and the best glottic view was captured. The second glottic image was taken following LeHeR in Group L and direct epiglottis lifting in Group E. Percentage of glottic opening (POGO) in both images was compared later by an anonymized anesthesiologist. Change in POGO, ease and time to intubation, hemodynamic responses, and desaturation < 95% were compared in both groups.
resultsDemographics and baseline airway variables were comparable. Both maneuvers significantly improved intragroup POGO scores ( P ≤ 0.001). The median second POGO was higher with epiglottis lifting than LeHeR technique (100 [interquartile range 75-100] vs. 75 [75-100], P = 0.03). Improvement in glottic view occurred in 96.7% of patients in Group E versus 63.3% in Group L ( P = 0.002). Time to intubation (33 ± 12 vs. 31 ± 10 s), ease of intubation, hemodynamics, and incidence of desaturation were comparable.
conclusionDirect epiglottis lifting with C-MAC videolaryngoscope D blade provided significantly improved glottic visualization compared to LeHeR with comparable intubation time in patients with difficult airway.
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