Abstract :
Aims: Difficult tracheal intubation still contributes significantly to anaesthesia related morbidity and mortality. Poor visualisation of laryngeal structures and multiple attempts at intubation are the leading causes with the conventional laryngoscopes. Though the recently introduced video assisted devices have significantly improved the ease of intubation by their superior laryngeal visualisation, the duration of intubation may vary. Here we compared the ease of tracheal intubation using Macintosh conventional
direct laryngoscope (DL) and C- MAC videolaryngoscope (VL) in patients with expected difficult tracheal intubation.
Materials and Methods: A total of 140 patients undergoing elective surgery under general anaesthesia with Modified Mallampati Class 3 and 4 found during the preoperative airway assessment were equally recruited to either of the groups. We compared the duration of tracheal intubation, visualisation of the laryngeal inlet, additional optimising manoeuvres required, and number of attempts at intubation and incidence of oral trauma assessed at extubation between the two groups.
Statistical Analysis: Analysis done using Statistical Packages for the Social Sciences (SPSS) software; Windows version 11.0 (SPSS Inc., Chicago, IL, USA).
Results: Intubation time was significantly longer in patients with VL than DL (P 0.0001) whereas visualisation of laryngeal inlet was significantly better with VL (P 0.001). Additional optimisingmanoeuvres (P 0.001) and incidence of oral trauma (P 0.012) were significantly less with VL whereas intubation attempts were found comparable (P 0.586).
Conclusion: Though VL provided significantly better laryngeal view with less need for optimising manoeuvres and less oral trauma compared to DL, the duration of intubation was significantly more with the former.
Keyword :
Anaesthesia; C MAC-D Blade, Difficult airway, Intubation, Laryngoscope.