Comparison between Conventional Macintosh Laryngoscope and King Vision Video Laryngoscope in Endotracheal Intubation for Elective Surgeries: A Prospective Randomized Study

JOURNAL TITLE: Research and Innovation in Anesthesia

Author
1. Sunil K Gvalanil
2. Shalaka R Sonavane
3. Pratika P Bhokare
ISSN
DOI
10.5005/jp-journals-10049-0090
Volume
5
Issue
2
Publishing Year
2020
Pages
5
Author Affiliations
    1. Department of Anesthesia, HBT Medical College and Dr RN Cooper Hospital, Mumbai, Maharashtra, India
    1. Department of Anesthesia, HBT Medical College and Dr RN Cooper Hospital, Mumbai, Maharashtra, India
    1. Department of Anesthesia, HBT Medical College and Dr RN Cooper Hospital, Mumbai, Maharashtra, India
  • Article keywords
    Intubation, King Vision, Macintosh, Pressor response, Prospective randomized study

    Abstract

    Introduction: Securing the airway with an endotracheal tube is an essential anesthesia skill. Despite improvements in intubation devices, tracheal intubation is still accomplished using the traditional method of direct laryngoscopy.1 The failure of direct laryngoscopy to provide an adequate glottic visualization, coupled with a major pressor response, has led to the development of newer intubation devices. Video laryngoscope is one such intubation device with advantages of a higher success rate, better glottic visualization, safer intubation, faster learning curve, and the opportunity for dynamic interaction during airway management.3 In our study, we have used King Vision Video Laryngoscope (KVVL) for tracheal intubation and compared its efficacy, ease, safety, and shorter learning curve with that of the conventional Macintosh direct laryngoscope. The laryngoscopic view, hemodynamic response, and the attempts and time of endotracheal intubation of both Macintosh and KVVL have been compared in this prospective randomized study. Materials and methods: A total of 200 patients were assigned into two groups, I and II, where group I consists of patients receiving general anesthesia with endotracheal intubation using conventional Macintosh blade; and group II consists of patients receiving general anesthesia with endotracheal intubation using KVVL. Preoperative anesthesia check-ups and airway assessments were done which included mouth opening, MPC grading, and measurement of thyromental distance. The parameters studied were laryngoscopy view (using modified Cormack–Lehane scoring system), assessment of laryngoscopy and intubation procedure (number of attempts for successful intubation, maneuvers used during laryngoscopy, endotracheal tube insertion time), and hemodynamic response (heart rate, mean arterial blood pressure, and SpO2). Results: The hemodynamic response to laryngoscopy and intubation was significantly lower with KVVL. Also, KVVL had superior glottic vision and less maneuver requirement during laryngoscopy. Conclusion: From our study of comparison between Macintosh and KVVL, we conclude that KVVL is more effective in reducing hemodynamic response to intubation and requires less optimization maneuvers. Clinical significance: This study aims at providing evidence to guide the anesthesiologists regarding the merits and demerits of video laryngoscopes and aid them in safer airway management techniques without complications.

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