Abstract
The laryngoscopy is known to have profound cardiovascular effects. This includes pressor response and tachycardia along with an increase in catecholamine concentration, mainly norepinephrine. The major cause of the sympathoadrenal response is believed to arise from stimulation of supraglottic region by laryngoscopic blade with tracheal tube placement and cuff inflation contributing little additional stimulation. Complications of pressor respo laryngoscopy include myocardial ischemia, cardiac failure, intracranial haemorrhage and increase in intracranial pressure. Hence the present study planned to evaluate the laryngeal view and pressor response by using three different blades – Macintosh, McCoy and Miller laryngoscopes.
 The study was planned in the Department of Anaesthesia in Andaman and Nicobar Islands Institute of Medical Science (ANIIMS), Port Blair India, From Jun 2016 to Jun 2017 . The 30 patient undergoing the Laryngoscopy were enrolled in the present study. For the 10 patients using the Macintosh Blade were divided in Group I. The next 10 patients using the Miller blade were considered in the Group II. The remaining 10 patients were studied by use of McCoy blade.
 The results in our study show that the MacCoy laryngoscope blade improves the visualization of the larynx and significantly attenuates haemodynamic parameters during laryngoscopy and intubation as compared to that with Macintosh laryngoscope blade.
 Keywords: Laryngoscopy, Intubation, pressor response, Macintosh, miller and Mccoy laryngoscopes, etc
Highlights
Laryngoscopy is endoscopy of the larynx, a part of the throat
The results in our study show that the MacCoy laryngoscope blade improves the visualization of the larynx and significantly attenuates haemodynamic parameters during laryngoscopy and intubation as compared to that with Macintosh laryngoscope blade
This procedure is most often employed by anaesthetists for endotracheal intubation under general anaesthesia, and in direct diagnostic laryngoscopy with biopsy
Summary
Laryngoscopy is endoscopy of the larynx, a part of the throat. It is a medical procedure that is used to obtain a view, for example, of the vocal folds and the glottis. Direct laryngoscopy is carried out (usually) with the patient lying on his or her back; the laryngoscope is inserted into the mouth on the right side and flipped to the left to trap and move the tongue out of the line of sight, and, depending on the type of blade used, inserted either anterior to the epiglottis and lifted with an upwards and forward motion ("away from you and towards the roof ") This move makes a view of the glottis possible. There are many other styles of curved and straight blades (e.g., Phillips, Robertshaw, Sykes, Wisconsin, Wis-Hipple, etc.) with accessories such as mirrors for enlarging the field of view and even ports for the administration of oxygen These specialty blades are primarily designed for use by anesthetists, most commonly in the operating room.[4] paramedics are trained to use direct laryngoscopy to assist with intubation in the field. The laryngeal view obtained was compared according to Cormack and Lehane [6] grading as follows
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