A Comparative Study of Glottic Visualization and Ease of Intubation with McCoy and Macintosh Laryngoscopes
Shahid Adalat Chaudhry, Muhammad Nadeem Khan, Mubashar Iqbal
598
ABSTRACT
Introduction: The anaesthetist
should protect the airways during induction, recovery and maintenance during anaesthesia.
The Macintosh blade is the utmost prevalent blades with a slightly back curved
that extends all the way to the tip. The McCoy blade is grounded on a normal
Macintosh blade with a hinged tip and is functioned by a lever mechanism located
at the handle back.
Objective: This study attempts
to compare McCoy and Macintosh blades to facilitate intubation for glottis
imaging.
Place and Duration: In the Department of
Anesthesia, Divisional Headquarter teaching
Hospital Mirpur Azad Kashmir for six months duration from June 2021 to
November 2021.
Method: The study included 70
Grade I and II ASA adults of both sexes (20 to 60 years) who endured planned
surgery under GA necessitating intubation by endotracheal tube. Using a computer-generated
randomization table, individuals were assigned randomly to any of the 2 groups contingent
on the type of laryngoscope blades used while doing intubation. After anaesthesia
induction, ‘laryngoscopy’ was done and the intubation of trachea was done. McCoy
Laryngoscope Blade was used in In Group A while Macintosh Laryngoscope Blade in
Group B. The number of trials, Cormack Lehane classification, the necessity for
external laryngeal manipulation and degree of intubation difficulty were evaluated.
Results: Both groups were
comparable for sex, weight, age, height, MPC grading, ASA status and among the
two groups; no statistically significant alteration was noted (p-value>
0.05). In Group A and B Cormack Lehane classification in Grade-I scored 82.9%
and 60%, correspondingly, while Grade-II scoring in Group A and B were 17% and
25.8%, correspondingly. The Grade-I Intubation Difficulty score (IDS) in Groups
A and Group B were 88.6% and 80%, respectively, while Grade-II IDS in Groups A
and B were 11.4% and 14.2%. 8.5% of patients in group A and 5.7% of patients in
group B required two intubation attempts.
Conclusion: There are no
significant fluctuations to the glottis visualization with Macintosh and McCoy
laryngoscopes, but in terms of external manipulation of larynx, the McCoy
laryngoscope is superior to the Macintosh laryngoscope in terms of comfort of
intubation.
Keyword: endotracheal tube, Macintosh
blades, Macintosh and McCoy laryngoscopes.
ABSTRACT
Introduction: The anaesthetist
should protect the airways during induction, recovery and maintenance during anaesthesia.
The Macintosh blade is the utmost prevalent blades with a slightly back curved
that extends all the way to the tip. The McCoy blade is grounded on a normal
Macintosh blade with a hinged tip and is functioned by a lever mechanism located
at the handle back.
Objective: This study attempts
to compare McCoy and Macintosh blades to facilitate intubation for glottis
imaging.
Place and Duration: In the Department of
Anesthesia, Divisional Headquarter teaching
Hospital Mirpur Azad Kashmir for six months duration from June 2021 to
November 2021.
Method: The study included 70
Grade I and II ASA adults of both sexes (20 to 60 years) who endured planned
surgery under GA necessitating intubation by endotracheal tube. Using a computer-generated
randomization table, individuals were assigned randomly to any of the 2 groups contingent
on the type of laryngoscope blades used while doing intubation. After anaesthesia
induction, ‘laryngoscopy’ was done and the intubation of trachea was done. McCoy
Laryngoscope Blade was used in In Group A while Macintosh Laryngoscope Blade in
Group B. The number of trials, Cormack Lehane classification, the necessity for
external laryngeal manipulation and degree of intubation difficulty were evaluated.
Results: Both groups were
comparable for sex, weight, age, height, MPC grading, ASA status and among the
two groups; no statistically significant alteration was noted (p-value>
0.05). In Group A and B Cormack Lehane classification in Grade-I scored 82.9%
and 60%, correspondingly, while Grade-II scoring in Group A and B were 17% and
25.8%, correspondingly. The Grade-I Intubation Difficulty score (IDS) in Groups
A and Group B were 88.6% and 80%, respectively, while Grade-II IDS in Groups A
and B were 11.4% and 14.2%. 8.5% of patients in group A and 5.7% of patients in
group B required two intubation attempts.
Conclusion: There are no
significant fluctuations to the glottis visualization with Macintosh and McCoy
laryngoscopes, but in terms of external manipulation of larynx, the McCoy
laryngoscope is superior to the Macintosh laryngoscope in terms of comfort of
intubation.
Keyword: endotracheal tube, Macintosh
blades, Macintosh and McCoy laryngoscopes.