Comparative evaluation of intubating conditions and hemodynamic response to laryngoscopy and intubation with McCoy and Macintosh laryngoscopes ; a prospective randomized study

Background: Laryngoscopy and intubation is known to produce an exaggerated stress response. The aim in general anesthesia is to attenuate this stress response. Method: This was a prospective, randomized, and a single blinded study. Ethical committee approval was obtained and 100 patients, aged 20-50 years, ASA grade I and II of either gender undergoing elective surgery under general anesthesia at a tertiary care center in India between 2015 and 2016 were recruited. We compared the Macintosh and McCoy laryngoscope blades regarding intubation time, laryngoscopic view and hemodynamic variables. Results: Both groups were comparable regarding age, gender, height and baseline vitals. Patients intubated with McCoy blade showed no or minimal change in heart rate and mean arterial pressure as compared to Macintosh blade. The intubation time was comparable in both groups. Conclusion: McCoy blade was better in attenuating the stress response to laryngoscopy and tracheal intubation.

[1]  S. Purohit,et al.  Comparison of hemodynamic responses to intubation: Flexible fiberoptic bronchoscope versus McCoy laryngoscope in presence of rigid cervical collar simulating cervical immobilization for traumatic cervical spine , 2015, Anesthesia, essays and researches.

[2]  Sonal Sharma,et al.  COMPARISON OF HEMODYNAMIC RESPONSE TO TRACHEAL INTUBATION WITH MACINTOSH AND MCCOY LARYNGOSCOPES , 2015 .

[3]  N. Bharti,et al.  A comparison of McCoy, TruView, and Macintosh laryngoscopes for tracheal intubation in patients with immobilized cervical spine , 2014, Saudi journal of anaesthesia.

[4]  S. Singhal,et al.  Intraocular pressure changes following laryngoscopy and intubation- McCoy versus Macintosh laryngoscope , 2012 .

[5]  A. Badhe,et al.  Optimal external laryngeal manipulation versus McCoy blade in active position in patients with poor view of glottis on direct laryngoscopy , 2010, Indian journal of anaesthesia.

[6]  Neha,et al.  Haemodynamic Response To Laryngoscopy And Intubation: Comparison Of McCoy And Macintosh Laryngoscope , 2007 .

[7]  M. Bozkurt,et al.  Tracheal intubation using the ILMA, C‐TrachTM or McCoy laryngoscope in patients with simulated cervical spine injury , 2006, Anaesthesia.

[8]  U. Singh,et al.  Opioid sparing during endotracheal intubation using McCoy laryngoscope in neurosurgical patients: the comparison of haemodynamic changes with Macintosh blade in a randomized trial. , 2005, Journal of postgraduate medicine.

[9]  Dong Yeon Kim,et al.  Effect of Laryngoscopic and Tracheal Intubation Duration on Hemodynamic Response during Anesthetic Induction with Thiopental, Fentanyl and Rocuronium , 2005 .

[10]  H. Cho,et al.  A Comparison of the Effects of Different Types of Laryngoscope on Hemodynamics: McCoy Versus the Macintosh Blade , 1999 .

[11]  D. Benhamou,et al.  [Improvement of glottis visualization with a McCoy blade]. , 1998, Annales francaises d'anesthesie et de reanimation.

[12]  T. Nishiyama,et al.  [Which laryngoscope is the most stressful in laryngoscopy; Macintosh, Miller, or McCoy?]. , 1997, Masui. The Japanese journal of anesthesiology.

[13]  T. Cook,et al.  A comparison between the Macintosh and the McCoy laryngoscope blades , 1996, Anaesthesia.

[14]  J. Castillo,et al.  [Cardio-circulatory response to laryngoscopy. Comparative study between Macintosh and McCoy laryngoscopes]. , 1996, Revista espanola de anestesiologia y reanimacion.

[15]  J. Roman,et al.  [Hemodynamic response to intubation with Macintosh and McCoy blades]. , 1996, Revista espanola de anestesiologia y reanimacion.

[16]  R. Mirakhur,et al.  A comparison of the stress response to laryngoscopy , 1995, Anaesthesia.

[17]  E. McCoy,et al.  The levering laryngoscope , 1993, Anaesthesia.

[18]  T. Y. El-Sharkawy,et al.  Hemodynamic and catecholamine responses to laryngoscopy with vs. without endotracheal intubation , 1991, Acta anaesthesiologica Scandinavica.

[19]  G. Smith,et al.  Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. , 1987, British journal of anaesthesia.

[20]  R. Stoelting.  Circulatory changes during direct laryngoscopy and tracheal intubation: influence of duration of laryngoscopy with or without prior lidocaine. , 1977, Anesthesiology.