ABSTRACT
Background: To compare the safety and efficacy of Macintosh, McCoy and Truview laryngoscope in simulated difficult laryngoscopy using rigid neck collar in overweight patients. Methods: It was a Prospective, randomized, controlled clinical trial conducted in a tertiary care teaching hospital. Overweight patients (BMI= 25-29.9) with American Society of Anesthesiologists physical status I and II, age 18 to 60 years and scheduled recruited for elective surgery requiring general anesthesia with oral endotracheal intubation were included. The patients were divided into three groups comprising of 40 patients each in which Macintosh, McCoy and Truview laryngoscopes were used respectively. Difficult laryngoscopy was simulated using rigid neck collar. The primary outcome measure was modified Intubation Difficulty Score (IDS ). The secondary outcome measures were number of attempts, ease of intubation, overall success rate, time of intubation, Percentage of Glottic Opening score, hemodynamic parameters and complications. Results: The mean Intubation Difficulty Score was significantly lower with Truview Laryngoscope (1.68) as compared to Macintosh (4.21)and MacCoy (3.03) laryngoscopes. The median Percentage of Glottic Opening score was also significantly improved in the Truview group(78.21) compared to the other groups. Number of successful first intubation attempt was significantly higher in the Truview group(63.16%) compared to the other groups. The overall success rate was similar among groups. However, the time of intubation was significantly higher for Truview (41.21±2 sec) compared to Macintosh and McCoy laryngoscopes. Conclusion: The Truview laryngoscope allowed better glottic visualization, greater ease of intubation, fewer intubation attempts, but a longer intubation time compared to Macintosh and MacCoy laryngoscopes.
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