A comparative study of use of Macintosh Laryngoscope versus light wand with respect to duration and number of attempts required and failure rate in general anaesthesia
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 10
Abstract
Introduction: The anaesthesiologists play a very important role in health care, rendering patient free from pain either in the form of regional anaesthesia, local anaesthesia or general anaesthesia to facilitate surgical procedure. The primary responsibility as a clinician is to safeguard the airway i.e. to preserve and protect it during induction, maintenance and recovery from the state of anaesthesia and in the event of loss of the airway, it should be promptly re-established before the individuals suffers irreversible injury from inadequate or compromised oxygenation. Failure to maintain a patent airway for more than a few minutes results in hypoxia, hypercarbia, metabolic alterations, brain damage or death. More than 85% of all respiratory related closed malpractice claims involve a brain damaged or dead patient. Difficult intubation remains one of the major risks in anaesthesia practice Aims and Objective: To compare the ease of intubation using Macintosh Laryngoscope and Lightwand device in terms of: Duration of intubation, Number of attempts. Methodology: Our study was a randomized prospective study consisting of 180 patients (90 in each group) posted for surgical procedures under general anaesthesia. The Ethics Committee approval was obtained to conduct the study. 180 patients were scheduled. They were randomly assigned to each group of intubation device: The Macintosh Laryngoscope (LS) and The Lightwand (LW) group. Result: . The mean total time taken for intubation (T=T1+T2) in Lightwand group was 58.78 ± 17.86 seconds whereas in the Macintosh group it was 36.17 ± 9.75 seconds. The P value is 0.000*. P value is <0.05 and is statistically significant. In Lightwand group 5.6% (6) patients‟ required optimizing maneuvers like jaw lift and hyper-extension of neck, while in Macintosh group no patients required optimizing maneuvers like External laryngeal pressure. P value is 0.045. P value is <0.05 and it is statistically significant. The mean umber of attempts in Lightwand group was 1.34 ± 0.48 whereas in McIntosh group was 1.11 ± 0.32. P value is 0.000. P value is <0.05 and it is statistically significant. Conclusion: Overall the mean duration and attempts of intubations are more in the Lightwand group as compared to McIntosh group.
Authors and Affiliations
Poonam Shriram Thakur, Rajendra D Patel
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