IJSR - International Journal of Scientific Research

Dr. Arnab Paul; Dr. (Col) V. R. R. Chari; Dr. Vinit Garg; Dr. Bhoomi Raval; Dr. Farha Nasreen

Volume : VI, Issue : I, January - 2017

COMPARISON OF GLOTTIC VISUALIZATION AND EASE OF INTUBATION WITH MACINTOSH AND McCOY LARYNGOSCOPES

Dr. Arnab Paul, Dr. Col V. R. R. Chari, Dr. Vinit Garg, Dr. Bhoomi Raval, Dr. Farha Nasreen

Abstract :

Introduction: An Anaesthesiologist should secure the airway during induction, maintenance of anaesthesia and recovery from anaesthesia. The Macintosh blade is one of the most popular blades with a gentle curved tongue which extends to the tip. McCoy is based on the standard Macintosh blade which has a hinged tip and operated by a lever mechanism on the back of the handle.

Aim: An attempt has been made to compare the Macintosh and McCoy blade for the glottis visualization, with regard to the difference in the ease of intubation .

Method: Institutional Ethics Committee approval was taken prior to commencement of study. An informed and written consent was taken from every patient selected for the study. 60 adults (18 – 60 years) of both sexes, ASA Grade I & II, undergoing elective surgery under general anaesthesia requiring endotracheal intubation were enrolled in this study. . Using computer generated random allocation chart, patients were randomly allocated to one of the two groups depending upon the types of laryngoscope blade was used during intubation. After induction of anaesthesia laryngoscopy was performed and trachea intubated. Group A – where McCoy Laryngoscope blade was used, Group B – where Macintosh Laryngoscope blade was used. Cormack Lehane grading, number of attempts, intubation difficulty score and need for external laryngeal manipulation were assessed. Statistical Analysis: Statistical analysis was done by using SPSS. . Student t–Test, chi square test were applied according to the requirement. The level of significance was fixed at 95%. P<0.05 was considered as statistically significant.

Results: Cormack Lehane Grade 1 view was obtained by group A and group B are 80% and 66.7% respectively, where grade 2 view obtained by group A & group B are 20% and 26.7% respectively (p> 0.05). Intubation difficulty score (IDS) grade 1 in group A and group B are 93.3% and 86.7% respectively, where IDS grade 2 in group A and group B are 6.7% and 10% respectively (p > 0.05), 26.7% patients from group B needed external laryngeal manipulation where no patient from group A needed it which is statistically significant (p <0.05).

Conclusion: There is no significant change in glottic visualization with McCoy and Macintosh laryngoscope but as far as external laryngeal manipulation is concerned, McCoy laryngoscope is better than the Macintosh laryngoscope for the ease of intubation.