Back
 OJAnes  Vol.3 No.5 , July 2013
Comparison of Laryngoscopic View and Hemodynamic Changes with Flexitip McCoy and Macintosh Laryngoscope Blade in Predicted Easy and Difficult Airway
Abstract: Objective: To compare the laryngoscopic view and the hemodynamic changes by using flexitip McCoy laryngoscope with Macintosh laryngoscope. Method: Study design-Prospective randomized controlled study. A total of 220 patients were included in the study. Patients were allocated on the basis of their airway anatomy in to two groups, one is predicted easy group and the other one was predicted difficult airway group. Among each group, half of the patient intubation was performed with Macintosh blade and the other half was intubated with the help of McCoy blade. The airway prediction was done on the basis of Mallampati grade, thyromental distance, inter incisor gap, jaw protrusion and weight of the patient. Larygoscopic view and hemodynamic changes were recorded. Results: The change in pulse rate was significantly (p = 0.01) higher among the patients of Group B (85.02 ± 10.13) as compared to Group A (79.20 ± 13.11) after induction in predicted easy patients. Similar observation was found for pulse rate after laryngoscopy among both predicted easy and difficult patients. The diastolic blood pressure was significantly (p = 0.0001) higher in Group B (86.34 ± 9.78) than Group A (77.12 ± 11.66) after induction among predicted easy patients. However, diastolic blood pressure was significantly (p = 0.0004) higher in Group A (82.00 ± 10.98) compared with Group B (75.00 ± 9.06) after induction among predicted difficult patients. The average time taken during laryngoscopy was in-significantly (p > 0.05) higher in Group B (13.90 ± 5.95) compared with Group A (12.42 ± 3.58) among predicted easy patients. However, the time taken was significantly (p = 0.0001) higher in Group A (20.83 ± 2.47) than Group B (12.66 ± 3.0) in predicted difficult patients. A majority of the patients of both the groups were in Grade I (Group A = 61.8%, Group B = 81.8%) followed by Grade II (Group A = 38.2%, Group B = 18.2%) among predicted easy patients. Conclusion: It was concluded that the McCoy blade may be an answer to Macintosh blade in difficult airway cases, but not the substitute of Macintosh blade in every case. The McCoy blade improved laryngeal view in patients with limited neck extension.
Cite this paper: Z. Arshad, H. Abbas, J. Bogra and S. Saxena, "Comparison of Laryngoscopic View and Hemodynamic Changes with Flexitip McCoy and Macintosh Laryngoscope Blade in Predicted Easy and Difficult Airway," Open Journal of Anesthesiology, Vol. 3 No. 5, 2013, pp. 278-282. doi: 10.4236/ojanes.2013.35061.
References

[1]   T. M. Cook and J. P. Tuckey, “A Comparison between the Macintosh and the McCoy Laryngoscope Blades,” Anaesthesia, Vol. 51, No. 10, 1996, pp. 977-980. doi:10.1111/j.1365-2044.1996.tb14971.x

[2]   E. P. McCoy, R. K. Mirakhur and B. V. McCloskey, “A Comparison of the Stress Response to Laryngoscopy. The Macintosh versus the McCoy Blade,” Anaesthesia, Vol. 50, No. 11, 1995, pp. 943-946. doi:10.1111/j.1365-2044.1995.tb05924.x

[3]   T. Nishiyama, T. Higashizawa, H. Bito, A. Konishi and T. Sakai, “Which Laryngoscope Is the Most Stressful in Laryngoscopy; Macintosh, Miller or McCoy?” Masui. The Japanese Journal of Anesthesiology, Vol. 46, No. 11, 1997, pp. 1519-1524.

[4]   J. B. Li, Y. C. Xiong, X. L. Wang, X. H. Fan, Y. Li and H. Xu, et al., “An Evaluation of the Truview EVO2 Laryngoscope,” Anaesthesia, Vol. 62, No. 9, 2007, pp. 940-943. doi:10.1111/j.1365-2044.2007.05182.x

[5]   M. Barak, P. Philipchuck, P. Abecassis and Y. Katz, “A Comparison of the Truview Blade with the Macintosh Blade in Adult Patients,” Anaesthesia, Vol. 62, No. 8, 2007, pp. 827-833. doi:10.1111/j.1365-2044.2007.05143.x

[6]   G. L. Samsoon and J. R Young, “Difficult Tracheal Intubation: A Retrospective Study,” Anaesthesia, Vol. 42, No. 5, 1987, pp. 487-490. doi:10.1111/j.1365-2044.1987.tb04039.x

[7]   T. M. Cook, R. M. Levitan, A. Ochroch and J. Hollander, “POGO Score,” Canadian Journal of Anaesthesia, Vol. 47, No. 5, 2000, pp. 477-478. doi:10.1007/BF03018985

[8]   I. Singh, A. Khaund and A. Gupta, “Evaluation of Truview EVO2 Laryngoscope in Anticipated Difficult Intubation: A Comparison to Macintosh Laryngoscope,” Indian Journal of Anaesthesia, Vol. 53, No. 2, 2009, pp. 164-168.

[9]   T. Uchida, Y. Hicawa, Y. Saito and K. Yasuda, “The McCoy Levering Laryngoscope in Patients with Limited Neck Extension,” Canadian Journal of Anaesthesia, Vol. 44, No. 6, 1997, pp. 674-676. doi:10.1007/BF03015455

[10]   J. P. Tuckey, T. M. Cook and C. A. Rander, “Forum. An Evaluation of the Levering Laryngoscope,” Anaesthesia, Vol. 51,No.1, 1996, pp. 71-73.

 
 
Top