Interaction Between Head/Neck Position and C-MAC Blade Geometry on Videolaryngoscopic Intubation in Morbidly Obese Patients: A Randomized Controlled Trial

Interaction Between Head/Neck Position and C-MAC Blade Geometry on Videolaryngoscopic Intubation in Morbidly Obese Patients: A Randomized Controlled Trial

This study aims to explore the effect of head/neck position (sniffing vs ramped) and C-MAC blade geometry (MAC vs D-blade) on intubation in morbidly obese patients.

The patients will be randomized into 4 groups:

1. S MAC: Sniffing + MAC blade.
2. R MAC: Ramped + MAC blade.
3. S D-blade: Sniffing + D-blade.
4. R D-blade: Ramped + D-blade.

Inclusion Criteria:

• Age 18-70 years.
• BMI ≥ 40 kg/m².
• ASA physical status III - IV.
• Elective surgery requiring intubation.
• Informed consent obtained.

Exclusion Criteria:

• Anticipated difficult airway unrelated to obesity.
• Cervical spine pathology.
• Pregnancy.
• Emergency surgery.
• High aspiration risk.
• OSA requiring CPAP >15 cmH₂O.
• Need for awake intubation.