Cervical Spine Movement and Ease of Intubation Using Truview or McCoy Laryngoscope in Difficult Intubation.

Abstract

Prospective, observational, analytical, randomized control trial. To compare cervical spine movement for best laryngoscopic view and ease of intubation using Truview or McCoy laryngoscope in anticipated difficult intubation. The addition of modified laryngoscope blade to the anesthesiologist's armamentarium adds flexibility and improves the skill of the anesthetist, which benefits the patients. One hundred patients of American Society of Anesthesiologists status I and II with predicted difficult intubation score ≥5 were divided into two groups: Group A (n = 50): intubation done with McCoy laryngoscope and Group B (n = 50): intubation done with Truview laryngoscope and compared for the ease of intubation using intubation difficulty scale (IDS), cervical spine movement, and hemodynamic alterations. The total IDS determining the ease of tracheal intubation was better in Group B than Group A. On comparing the variables of IDS score, there was no difference between the two groups except 14 (28%) patients in Group A required application of external laryngeal pressure, whereas only five (10%) patients had this difficulty in Group B. It was seen that craniocervical extension was significantly less (2.5 times) in Group B as compared to Group A. In anticipated difficult intubation, Truview improves the laryngeal view, causes less movement at cervical spine, which could be more helpful in patients with restricted neck mobility, and has lesser complications. 2.