Comparison of the stress response and intubating performance in endotracheal intubation with Macintosh and McCoy laryngoscopes

Abstract

Introduction: Laryngoscopy and intubation cause stress response and sympathetic stimulation within the body. Attenuation of these changes by pharmacological means and improved technique with modified instruments is of absolute importance, for stable hemodynamics of the patients. Aim: Comparison of stress response to laryngoscopy and intubation, Intubation Difficulty Score (IDS) using Macintosh and McCoy laryngoscopes. Material and methods: After obtaining institutional ethical committee approval and patient consent in this randomized study, sixty patients of ASA grade I and II, posted for elective surgery under general anaesthesia were intubated with Macintosh or McCoy laryngoscopes. Changes in heart rate, mean arterial pressure, systolic and diastolic blood pressure were observed upto 15 minutes after laryngoscopy, along with IDS. Results: McCoy group when compared with Macintosh group had significant reduction in heart rate at T0 (p value <0.0001), systolic blood pressure at T0, T1 and T15 (p value < 0.001), diastolic blood pressure at T0, T10 and T15 (p value <0.05), mean arterial blood pressure at T0, T10 and T15 (p value <0.05) was observed in this study. Conclusion: Hemodynamic stress response with McCoy blade laryngoscope was reduced in magnitude in comparison with Macintosh blade laryngoscope.