Assesment of Macintosh laryngoscope and Truview EVO2 video-laryngoscope with respect to hemodynamic and intubation quality in patients with presumptive difficult intubation

Abstract

This study aims to compare Macintosh laryngoscope and Truview EVO2 video-laryngoscope with respect to the quality of glottic image, the success rate of intubation and their impact on the duration of intubation, hemodynamic responses and also related complications in patients with expected difficult intubation according to the Mallampati scoring system. Sixty patients in ASA I-II group ranging from 18-65 years of age were included in the study. Patients were randomly divided into two groups of 30 cases as group M (the group intubated with Macintosh laryngoscope) and Group V (the group intubated with Truview EVO2 video-laryngoscope). C-L (Cormack-Lehanne) score detected during intubation, duration of intubation, neck extansion needs, the success of intubation, complications, and antihypertensive requirement were recorded. Preoperatively, before induction, after induction, immediately after intubation, after intubation, 1st, 2nd, 3rd, 4th and 5 minute heart rate, systolic artesial pressure, diastolic arterial pressure, mean arterial pressure, peripheral oxygen saturation were recorded. There was a significant difference between both groups as for the quality of glottic images obtained. C-L III score was rated for 1 patient in Group M, and 10 patients in Group V (p<0.05). Duration of intubation was 23 secs in Group M, and 42 secs in Group V, respectively (p<0.05). During intubation neck extension was significantly higher in Group M (p<0.05). Bleeding complication was observed in one patient's mouth during intubation in Group M while no complications were observed in Group V (p>0.05). Number of attempts of intubation, hemodynamic parameters and need for antihypertensive showed no significant difference between the two groups (p>0.05). Truview EVO2 video-laryngoscope may be preferred to Macintosh blade laryngoscope because of better glottic and orafaringeal image acquisition in patients expected with difficult intubation and providing successful intubation in patients with contraindicated neck extension. © 2011 OMU All rights reserved.