Online ISSN: 2515-8260

Comparative Assessment of Intubating Conditions using Macintosh Laryngoscope with Video Laryngoscope in Adult Patient Undergoing Elective Surgical Procedures in a Tertiary Care Hospital

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Heena Iqbal Memon1 , Niteen Khanderao Nadanwankar2

Abstract

Introduction: The gold standard method of airway management for general anaesthesia and resuscitation is tracheal intubation with laryngoscope. Airway manipulation or instrumentation is noxious producing adverse reflex mediated cardiovascular changes. Tuoren video laryngoscope was designed with highly angled blades that pass around the tongue and allow a “look around the corner” to the glottis opening. The view obtained includes tip of the blade and therefore allows visual guidance of the tip of the blade into the vallecula. This present study was undertaken to evaluate and compare the efficacy of Macintosh laryngoscope and Tuoren video laryngoscope with respect to time for intubation. Methods: The present prospective randomized comparative clinical study was conducted in a tertiary care hospital amongst 100 patients belonging to ASA physical grading I and II of either gender, aged 18- 60 undergoing elective surgical procedures under general anaesthesia. They were randomized in to two groups: 1. Group ML (Macintosh laryngoscope): 50 patients and 2. Group VL (Tuoren Video laryngoscope): 50 patients. Results: The mean age of patients in Group ML was 39.48±10.07 years and Group VL was 37.34±10.56 years. 6 Patients from Group ML required BURP while, 6 patients required lifting force in Group ML In this study, 4 patients required use of stylet while 6 patients required use of bougie in Group ML. 38 (76%) patients in Group ML and 23 (46%) patients in Group VL had slight difficulty during intubation. (IDS Score >0 & <5). The mean time taken for intubation in Group ML was 30.12±2.03 sec. and in Group VL was 20.9±1.59 sec. The mean basal HR in Group ML was 80.36 ±11.09 and in Group VL was 81.38±10.44. Mean HR after intubation at 1 min in Group ML was increased to 97.80±12.12 while it was 87.56 ± 10.78 in Group VL. A statistically significant difference was seen in both the groups (p=0.001). Mean Arterial blood pressure after intubation at 1 min in Group ML was decreased to 106.82±5.55 while it was further decreased to 94.64± 6.61 in Group VL. Conclusion: Finally, we conclude that Tuoren video laryngoscope when compared to Mcintosh laryngoscope improves the visualization of the larynx, is associated with less difficult airway maneuvers, lesser airway morbidity, takes less time for intubation and reduces the stress response to laryngoscopy.

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