Comparison of HC video-laryngoscope and Macintosh direct laryngoscope for tracheal intubation in pediatric patients

Abstract

Objective To compare HC video-laryngoscope and Macintosh direct laryngoscope for tracheal intubation in the pediatric patients.Methods One hundred and twenty pediatric patients,of ASA physical status [or Ⅱ (Mallampati class Ⅰ or Ⅱ),aged 1-6 yr,scheduled for elective surgery under general anesthesia,were randomly divided into 2 groups(n =60 each) using a random number table:HC video-laryngoscope group (group H1) and Macintosh direct laryngoscope group (group M1).Forty pediatric patients,aged 3-6 yr,of ASA physical status Ⅰ or Ⅱ (Mallampati class Ⅲ or Ⅳ,) suspected as having a difficult airway,scheduled for elective surgery under general anesthesia,were randomly divided into 2 groups (n =20 each) using a random number table:HC video-laryngoscope group (group H2) and Macintosh direct laryngoscope group (group M2).After induction of anesthesia,orotracheal intubation was carried out by HC video-laryngoscope (group H1 and H2) or by Macintosh direct laryngoscope (group M1 and M2).The exposure of the glottis was evaluated with Cormack-Lehane classification.The intubation time,rate of successful intubation,and distance between upper and lower incisors when intubation was successful in H2 and M2 groups were recorded.The development of damage to lips,teeth,gums and soft tissues of throat during intubation and hoarseness after operation was recorded.Results Compared with M1 group,no significant change was found in the intubation time,rate of successful intubation at first attempt and Cormark-Lehane grade,and the incidence of damage to lips,teeth,gums and soft tissues of throat during intubation and hoarseness after operation was significantly decreased in group H1.Compared with group M2,the intubation time was significantly shortened,the rate of successful intubation at first attempt was increased,the distance between upper and lower incisors when intubation was successful was reduced,Cormark-Lehane grade was decreased,and the incidence of damage to lips,teeth,gums and soft tissues of throat during intubation and hoarseness after operation was significantly decreased in group H2.Conclusion Tracheal intubation guided by HC video-laryngoscope is convenient and rapid,provides higher success rate and induces smaller stimuli with fewer complications than that guided by Macintosh direct laryngoscope,and HC video-laryngoscope has priority in treating the pediatric patients with difficult airway. Key words: Laryngoscopes; Intubation, intratracheal; Child