Abstract
A COMPARISON OF GLOTTIC VISUALIZATION AND EASE OF INTUBATION BETWEEN MACINTOSH AND C-MAC VIDEO LARYNGOSCOPE BLADES IN MPC III AND IV

Dr. Sanjot Ninave and *Dr. Sonal Karmore

ABSTRACT

Introduction: Anaesthesia in a patient with a difficult airway can lead to direct airway trauma and morbidity from hypoxia and hypercarbia. Management of the difficult airway sometimes involves the increased application of physical force to the patient's airway than is normal, which can cause direct airway trauma. The reported frequency of difficult intubations is between 1.5% and 13%, which is a problem that requires a prompt solution. Although the likelihood of a difficult intubation can be estimated from preoperative measurements and scoring systems, obtaining direct access to the glottis during preoperative direct laryngoscopy can be difficult. This study was performed to evaluate the glottic visualization and ease of endotracheal intubation in anaesthetized, paralyzed adults having MPC III and IV with Macintosh blade and C –MAC video laryngoscope blade. Aim: To compare the efficacy of Macintosh vs C- MAC video laryngoscope blade. Methodology: This study was conducted after taking due approval from Institutional Ethical Committee and obtaining consent from patients. The prospective and randomized type study included 60 subjects of age group 18-75 years, randomly allotted in 2 groups of 30 each, using „chit in a box‟ method. Laryngoscopy and intubation were carried out in classical intubating position by a single trained anaesthesiologist (senior consultant), familiar to use of Macintosh and C – MAC video laryngoscope blades. Results: There was no statistically significant difference between the two groups as regarding demographic data (age, sex, body mass index, height and ASA physical status). The success rate was 100% in both groups. Intubation time was significantly higher 61.52 ± 33.84 seconds in group M compared to 21.64 ± 2.76 seconds in group V, p value < 0.05. As regard number of attempts, all of intubation were successful from the first attempt in group V, while the intubations were successful from the first attempt only in 22 patients in group M and 8 patients from the second attempt. Conclusion: From the results of the study we concluded that, Glottic visualization assessed using Cormack Lehane grading was significantly better with C- MAC video laryngoscope blade as compared to Macintosh blade. In terms of ease of intubation C-MAC video laryngoscope blade (86.67% grade I ease) had better outcome as compared to Macintosh blade (70% grade I ease).

Keywords: C-MAC, Macintosh, difficulty laryngoscopy, intubation.


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