Stress Response to Laryngoscopy:Comparison between Macintoshand Mccoy’s Type Laryngoscope Blades
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 1
Abstract
Introduction:Laryngoscopy and intubation is known to cause exaggerated hemodynamic response and increased intracranial pressure. Earlier studies have shown that the type of laryngoscope blade influences the degree of hemodynamic response to endotracheal intubation. The aim of the study was to to compare the stress response to laryngoscopy and endotracheal intubationwhile using Macintosh and McCoy type blades. Materials & Methods:It is a prospective, comparative study including 60 patients undergoing various surgical procedures requiring general anaesthesia and endotracheal intubation between age group 20-50 years of both sexes with ASA grade 1 and 2 were chosen. The 60 cases were divided into two groups randomly (using table of random numbers): Group A: 30 Patients undergoing laryngoscopy with the Macintosh blade (size 3) and; Group B: 30 patients undergoing laryngoscopy with the McCoy blade (size 3). After induction and neuromuscular blockade pre-intubation pulse and mean arterial pressure (MAP) was recorded. Orotracheal intubation was attempted at this stage using laryngoscope blade assigned to respective group. Pulse and MAP was recorded while the blade was being inserted in vallecula. Similar pulse and blood pressure was taken at 2 minute and 5 minute after laryngoscopy. Ease of intubation was noted by knowing total time required for intubation, need for BURP maneuver and occurrence of any complication. Data was analyzed using SPSS software ver. 21. Results: Time for Laryngoscopy was significantly less with McCoy blade as compared to Macintosh blades (16.2 sec vs 19.55 sec; p<0.01). BURP manuver was never required with Mccoy blade but with Macintosh blade it was required in 36.7% of patients (p<0.01). Both groups were comparable in terms of baseline hemodynamic parameters. Post-laryngoscopy and Intubation till 2 minutes, heart rate and mean arterial pressures were significantly higher with Macintosh group compared to Mccoy group. Conclusion: McCoy’s blade provides better visualization of larynx and intubating conditions with minimal haemodynamic response to laryngoscopy
Authors and Affiliations
Jayshree Vaswani, Chirag Malik, Yogesh Bhalerao, Varsha Vyas, Kirtika Chedda
Keywords
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- EP ID EP590324
- DOI 10.9790/0853-1601087680
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