Title : A comparative analysis of king vision video laryngoscope with macintosh and mccoy laryngoscopes in adults undergoing elective surgical procedure
Abstract:
Background: The need to secure a patient’s airway is not only of vital importance in any emergency situation but also a routine part of general anaesthesia. The use of the laryngoscope facilitates endotracheal intubation but the force applied by it on the base of the tongue when elevating the epiglottis is the major stimulus for a pressor response. Apart from the traditionally compared Macintosh (Group MT) and McCoy blades (Group MC), the addition of the King Vision Video Laryngoscope (Group KV) and the parameters assessed make this a novel study.
Objectives: To determine the ease of intubation and compare the hemodynamic response with Macintosh, McCoy and King vision video laryngoscope.
Methodology: This study was a prospective analytical study done in Father Muller Medical College. Patients who are going to be intubated are randomized using computer generated randomization tables and are sorted into the three groups depending on the blade used at the time of intubation. The ease of intubation is assessed based on glottic visualization using Cormack-Lehane Grading, number of attempts, lifting force required and need for external manipulation of the larynx. Heart rate and Blood Pressure were recorded preoperatively, prior to and then immediately after laryngoscopy & intubation and thereafter 1, 3, and 5 minutes later to ascertain the hemodynamic response.
Results: 105 individuals were included in our study, 35 patients per group. It was noted that that Group KV had a higher incidence of Cormack Lehane grade 1 view when compared to MC and MT (88.5% VS 57.1% VS 74.3%), lower incidence of increased lifting force required (5.7% VS 20% VS 17.1%) and lowest incidence of need for optimal external manipulation (5.7% VS 25.7% VS 31.4%). It was however noted in our study that in attenuating the hemodynamic response there was no significant benefit of one laryngoscope over the other.
Conclusion: This study demonstrated that the King Vision Video laryngoscope is superior to Macintosh and McCoy blade with regard to ease of intubation, particularly with respect to improvement of the Cormack Lehane grading and a reduced need for external laryngeal manipulation, and that there is no benefit of one blade over the other with regard to hemodynamic parameters.
