Vol - 28, Issue - 04
About the Journal
[This article belongs to Volume - 28, Issue - 04]
International Medical Journal
Journal ID : IMJ-28-03-2021-815
Total View : 412

Abstract : Management of the airway is central to the practice of anaesthesia. The sole method used by anaesthesiologists to insert an endotracheal tube into the trachea was direct laryngoscopy for almost 60 years. There was a search for a better and bigger angle of vision especially during difficult intubations and this led to the development of devices using video assistance for laryngoscopy such as the C-MAC video laryngoscope. The aim of our study was to compare the C-MAC video laryngoscope and Macintosh laryngoscope with regards to glottic opening, ease of intubation and haemodynamic response. The study was conducted in the department of Anaesthesiology at DY Patil Medical College, Hospital and Research Centre, Pimpri, Pune. 60 patients between the ages of 18-65 years belonging to ASA class I and II undergoing elective surgery under general anaesthesia were studied as per the inclusion criteria. Group A patients were intubated with C-MAC video laryngoscope and Group B patients with Macintosh laryngoscope. Both groups were comparable with respect to their demographic profile. With respect to visualisation of the glottis, in the C-MAC group, 70% subjects had CL grade 1, 26.5 % subjects had CL grade 2 and 3.5 % subjects had CL grade 3. In the Macintosh group, 26.5 % subjects had CL grade 1, 40% subjects had CL grade 2 and 33.5 % patients had CL grade 3. This result is statistically significant (p <0.05). With regard to ease of intubation, 21 (70%) patients showed intubation difficulty score (IDS) grade 1 and 7 (24%) patients showed IDS grade 2 and 2 (6%) patients showed IDS grade 3 with CMAC. 3 (10%) patients showed IDS grade 1, 15 (50%) patients showed grade 2 and 12 (40%) patients showed grade 3 with Macintosh laryngoscope. This result is statistically significant (p <0.05). The need for external laryngeal manipulation or the use of a bougie to assist intubation was also significantly less in the C-MAC group as compared to the Macintosh group (p >0.05). Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure all did rise following laryngoscopy and intubation in both the groups but the changes were less significant with the C-MAC laryngoscope as compared to the Macintosh laryngoscope (P < 0.05). Based on our study, we concluded that there is improved glottic visualisation and there is more ease of intubation with the C-MAC video laryngoscope as compared to the Macintosh laryngoscope. The haemodynamic pressor response following laryngoscopy and intubation was less with the C-MAC video laryngoscope as compared to the Macintosh laryngoscope. There was no significant difference in the mean intubation time and the number of attempts between the two groups.

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