Comparison of hemodynamic changes during laryngoscopy with McCoy and Macintosh laryngoscopes

Abstract

Background: The Macintosh blade is one of the most popular blades with a gently curved tongue which extends to the tip. The McCoy blade laryngoscope has a hinge on the tip to avoid the lifting force in the vallecula reducing the amount of force exerted in the vallecula causing less hemodynamic changes. Aim: An attempt had been made to compare hemodynamic changes during laryngoscopy with Macintosh and McCoy laryngoscopes in adult patients undergoing elective surgeries. Settings and Design: It was a prospective, randomized, observational study conducted between October 1, 2013, and April 10, 2015. Materials and Methods: Institutional Ethics Committee approval was taken before the commencement of the study. An informed and written consent was taken from every patient selected for the study. Sixty adults (18–60 years) of both sexes, American Society of Anesthesiologists Grade I and II, undergoing elective surgery under general anesthesia requiring endotracheal intubation were enrolled in this study. Patients were randomly divided into two groups. Group A – where McCoy laryngoscope blade was used for laryngoscopy and Group B – where Macintosh laryngoscope blade was used for laryngoscopy. After induction of anesthesia, laryngoscopy was performed, and trachea was intubated. The change in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) was observed for 10 min post intubation. Statistical Analysis Used: It was done using SPSS. T-test and Chi-square test were applied according to the requirement. The level of significance was fixed at 95%. P < 0.05 was considered statistically significant. Results: McCoy group showed statistically significant lower values of mean HR, SBP, DBP, and MAP till 5 min after intubation when compared to Macintosh group (P < 0.05). Conclusions: HR, SBP, DBP, and MAP all did rise in both the group following laryngoscopy and intubation but changes with McCoy laryngoscope were less and statistically significant when compared to Macintosh laryngoscopes.