ABSTRACT
Background: In anesthetic practice, the introduction of multiple novel laryngoscopes has simplified visualization of the vocal cords and has reduced the complications arising due to difficult or failed tracheal intubation Both Truview scope and C-Mac video laryngoscope have been reported to provide a comparable or superior glottic view on comparison with conventional Macintosh laryngoscope Materials and methods: A randomized controlled study was conducted in 100 subjects scheduled for elective surgery equally divided into 2 groups Conventional Macintosh laryngoscopy was done initially in all subjects enrolled for the study For the Glottic view, One Group (n=50) underwent Truview laryngoscopy while the other (n=50) underwent C-Mac video laryngoscopy Results: The improvement in glottic view from original MCL (Modified Cormack & Lehane) grading obtained from Macintosh laryngoscope was 40% (n=23) in Truview compared to 46% (n=23) in CMac video laryngoscope while downgrading of view was observed in 10% (n=5) in group– T compared to none in C-Mac video laryngoscope There were no statistically significant difference in Intubation Difficulty Scale (IDS) scores between the groups (P = 0072) The mean duration of time R Vimal, A Sivanoli Comparison of Truviewscope and C-Mac Video Laryngoscope with the Conventional Macintosh Laryngoscope in Improving the Glottic View during Endotracheal Intubation IAIM, 2018; 5(12): 125-133 Page 126 for endotracheal intubation with C-Mac video laryngoscope (2310 seconds) was significantly shorter compared with Truview laryngoscope (3126 seconds) Conclusions: There was an improvement in view of the glottis in both Truview and C-Mac video laryngoscope from the initial Macintosh laryngoscope view But C-Mac video laryngoscope offered better view improvement and also required a shorter time for intubation compared to Truview laryngoscope
ABSTRACT
Background: Supraglottic airway devices (SAD’s) have revolutionized airway management both inside and outside the operating room ever since the invention of the LMA Classic. Objectives: Objective of this study was to compare efficacy of LMA classic, Ambu Aura laryngeal mask and I-gel in terms of ease of insertion, fiberoptic bronchoscopic assessment of the glottic view, oropharyngeal leak pressure, intra and post-operative complications. Material and methods: Ninety patients of ASA Grade 1 or 2, aged 18–70 years, scheduled for elective short surgical procedures requiring general anesthesia were randomly divided in to three groups as LMA Classic, Ambu Aura40 laryngeal mask and I-gel group whose airway were secured with these devices. Anesthetic technique was standardized and maintained on spontaneous breathing. The number of attempts for the correct positioning (at least 6 square Etco2 traces on the capnograph and 4 ml/kg tidal volume) of the device were counted. Glottic view was noted by fiberoptic bronchoscope passed into the supralottic device and graded as 1 = Vocal Cords entirely visible, 2 = Vocal Cords or Arytenoids Cartilages partially visible, 3 = Epiglottis only visible, 4 = No laryngeal structures visible. Oropharyngeal leak pressure (OPLP) was measured. Intra and post-operative complications were looked for and recorded. Results: Ambu Aura40 could be positioned successfully in a single attempt in 90% of the patients (27 out of the 30), whereas it’s only 80% in both the LMA Classic and the I-gel groups without a statistical significance (P = 0.518). Successful positioning during the next or second attempt was more with I-gel compared to LMA classic (20.0% and 16.7% respectively). 63.3% of Ambu laryngeal mask group had a glottic view grade of 1 while only 46.7% and 13.3% of patients in the LMA classic and the I-gel group had a similar glottic view respectively which was statistically significant (P = 0.000). Significantly higher mean OPLP with I-gel 36.23 ± 3.00 and least with LMA classic 30.90 ± 2.15 (p=0.000). 3 patients (10%) in the LMA Classic group complained of sore throat in the postoperative period which was statistically significant (P = 0.045). Conclusion: Over all Ambu Aura40 laryngeal mask airway device is superior in comparison to the other devices with respect to parameters studied. I-gel due to high oropharyngeal pressure leak could be useful in positive pressure ventilation. The LMA Classic is associated with a minimal incidence of sore throat in our study.