COMPARISON BETWEEN MACINTOSH AND LEVERING (McCOY's TYPE) LARYNGOSCOPE BLADE TO STUDY STRESS RESPONSE AND EASE OF INTUBATION.

Dr. SAURABH R. TODI; Dr. N.V. KANASE; Dr. V.K. DHULKHED

Volume : VIII, Issue : III, March - 2019

COMPARISON BETWEEN MACINTOSH AND LEVERING (McCOY's TYPE) LARYNGOSCOPE BLADE TO STUDY STRESS RESPONSE AND EASE OF INTUBATION.

Dr. Saurabh R. Todi, Dr. N. V. Kanase, Dr. V. K. Dhulkhed

Abstract :

INTRODUCTION:– The aim of laryngoscopy is to obtain good visualisation of vocal cords to facilitate smooth endotracheal intubation. Both laryngoscopy and intubation trigger major stress responses which can be catastropic in patients with ischaemic heart disease or hypertension. This study was undertaken with the aim to compare the hemodynamic responses, glottic view and intubating conditions using McCoy�s blade versus MacIntosh blade for intubation. MATERIALS AND METHODS:– A Prospective, Comparative, Single blind, Randomized Study was undertaken in Krishna Institute of Medical Sciences, Hospital and Research Centre, Karad, after obtaining ethical committee clearance as well as informed written consent from all patients. The study was carried from December 2016 to july 2018. 130 patients recruited for the study are randomly allocated into 2 groups i.e. into Group A and Group B of 65 patients each undergoing laryngoscopy with MacIntosh blade and McCoy�s blade respectively. RESULTS:– The haemodynamic response to laryngoscopy is significant if rise in the parameters such as heart rate, systolic BP, diastolic BP and mean BP is more than 20% above baseline values. After laryngoscope in macintosh v/s mccoy�s group 20% rise in heart rate was 92% and 81%, 20% rise in systolic BP was 40% and 20%, 20% rise in diastolic BP was 67% and 10%, 20% rise in mean BP was 55% and 4% was obtained respectively. Glottic view after laryngoscopy was compared using Cormack and Lehane�s grading(i.e. grade I to IV). In macintosh v/s mccoys group out of 65 patients grade I (is 70% and 86%), grade II (is 26% and 14%), grade III (is 6% and 0%), grade IV (is 0% in both group) was obtained respectively. Ease of intubation was compared using ease of intubation grading. In macintosh v/s mccoys group out of 65 patients grade 1(is 64% and 85%), grade 2 (is 36% and 15%), grade 3 and 4( is 0% in both groups) was obtained respectively. CONCLUSION:– we can say that McCoy�s blade shows overall minmal haemodynamic response and provides better glottic view and ease of intubation as compared to MacIntosh blade.