RESUMO
Background and Aims: Videolaryngoscopes with varying characteristics with regard to angulation of blades and video configurations are now available. However, the contribution of each of these in improving ease of intubation is quite different. We evaluated the role of video camera in the performance of laryngoscopy by using the universal serial bus (USB) videolaryngoscope in patients with predicted difficult airway. Methods: Sixty patients in the age group of 25 to 65 years having Mallampati grade III or IV were randomly allocated to two groups. All patients were American Society of Anesthesiologists physical status grade I or II and planned for elective surgical procedure under general anesthesia. USB videolaryngoscope or Macintosh laryngoscope was used for intubation as per group allotted. Comparison of time of endotracheal intubation was our primary outcome measure and it was calculated from the time the laryngoscope tip passes the incisors to the initial appearance of capnography wave. Rate of successful intubation, number of attempts needed for successful tube placement, optimisation manoeuvres used, changes in haemodynamic parameters and airway injuries were evaluated as secondary outcomes. Results: Time for intubation was shorter in the Macintosh group than the USB group (P = 0.024). The incidence of successful intubation was similar in both groups (P = 0.079). USB group required lesser number of attempts for tube placement (P = 0.047). The incidence of airway injuries was similar in both the groups. Conclusion: USB videolaryngoscope reduces the number of attempts required for successful endotracheal intubation compared to Macintosh laryngoscope though it increases the time for intubation in patients with predicted difficult airway.
RESUMO
Background and Aims: Studies on simulated difficult airway provide an opportunity to evaluate the performance of intubation devices for use in limited neck mobility. We did a comparative study between Split Type Postman videolaryngoscope and Macintosh laryngoscope, evaluating their efficacy for tracheal intubation in a simulated difficult airway. Methods: Sixty American Society of Anesthesiologists (ASA) physical status I and II patients aged between 20 and 60 years, having body mass index <30 kg m-2, posted for elective surgery under general anaesthesia were allocated to two groups. Endotracheal intubation was done with either Split Type Postman videolaryngoscope or Macintosh laryngoscope after placing a rigid cervical collar around the neck to simulate a difficult airway. The primary outcome measure was time for tracheal intubation as assessed from the time of introduction of laryngoscope between incisors till visual confirmation of passage of endotracheal tube through the vocal cords by the anaesthesiologist. Success rate of intubation, number of attempts required for successful intubation, haemodynamic alterations and airway complications were measured as secondary outcomes. Results: Time taken for endotracheal intubation was significantly shorter in Postman group (26.23 ± 7.18 vs. 31.43 ± 9.83 s) (P = 0.012) compared to Macintosh group. The groups were comparable in terms of incidence (P = 0.491) of successful intubation, with significantly lesser number of attempts required for intubation in Postman group (P = 0.022). The incidence of airway trauma and postoperative sore throat was comparable between the groups. Conclusion: Split Type Postman videolaryngoscope was superior with respect to intubation characteristics when compared to conventional laryngoscope.
