Comparison of the ease of Nasotracheal intubation and Haemodynamic response between Mc Coy laryngoscope and CMac video laryngoscope in patients undergoing maxillofacial surgery : A Prospective study

Singam Geetha; K.Geeta; R.Gopinath

Volume : VI, Issue : VIII, August - 2017

Comparison of the ease of Nasotracheal intubation and Haemodynamic response between Mc Coy laryngoscope and CMac video laryngoscope in patients undergoing maxillofacial surgery : A Prospective study

Singam Geetha, K. Geeta, R. Gopinath

Abstract :

Introduction: Nasotracheal intubation is often required for surgical access in patients posted for maxillofacial surgery. Intubation may be difficult due to airway oedema and trauma. Various designs of laryngoscopes are available in the clinical practice. Mc Coy laryngoscope has a hinged tip at the blade to elevate epiglottis aiding in intubation. C–Mac video laryngoscope has a small digital camera at the tip of the blade facilitating better glottis view over direct laryngoscopy.

Aims and objectiveness: to compare the intubation parameters ( duration of intubation, Number of attempts of intubation, Number of persons for intubation, Cormac–Lehane view of laryngoscopy, side effects and additional maneuvers) and haemodynamic response (HR, SBP, DBP,MAP.,SPO2) between CMac and Mccoy laryngoscopes.

Methods: We conducted a prospective randomized study on 50 patients divided into 2 groups (CMac group and MCcoy group) of 25 each. After connecting to monitors, our patients were premedicated, induced and intubated nasotracheally with CMac/ Mccoy laryngoscopes. The intubation response and haemodynamic response were observed.

Results: Demographic data was statistically similar in both Cmac and Mccoy groups in terms of age ( P=0.720), weight ( P= 0.157 ), height (P=0.426 ), gender ( P=0.609 ), and ASA grade( P=1.000). There was also no significant statistical difference in Haemodynamic response in both Cmac and Mccoy groups in terms of heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure and oxygen saturation . Regarding intubation response , Cmac laryngoscope is better than Mccoy laryngoscope in duration for intubation ( P<0.001 with Mean � SD of 40.76�10.25 seconds in CMac group and Mean � SD of 59.16�12.44 seconds in Mccoy group) and number of attempts (P=0.088 ) . other intubation parameters: No. of Persons required for intubation (P=0.490 ), Cormac lehane grade distribution (P=0.332 ), additional maneuvers required (P=0.702 and side effects (P=0.667 ) were almost comparable in both groups.

Conclusion: CMac laryngoscope improves nasotracheal intubation with less duration of intubation and less number of attempts than Mccoy laryngoscope. .