Online ISSN: 2515-8260

Keywords : endotracheal intubation


Endotracheal intubation in Cleft surgeries: A Comparison between Macintosh Laryngoscope and McGrath Mac Videolaryngoscope

Dr. Navaneetha Krishnan Srinivasan MBBS, MD, DNB; Dr. A Ajay Sriram MBBS, MD; Dr. Pradeep Karunagaran MBBS, MD; Dr.Porchelvan Swaminathan M.Sc,PhD,MBA, PGDCA; Dr. P U Abdul Wahab BDS, MDS

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1974-1981

Background: In recent anaesthesia practice, videolaryngoscopy is gradually replacing conventional Macintosh laryngoscopy in adult and paediatric patients particularly in difficult intubation scenario. In this study, we compared McGrath Mac videolaryngoscope and conventional Macintosh laryngoscope for laryngoscopy and endotracheal intubation in cleft lip and palate surgeries.
Aim: To compare and assess the ease of placement of endotracheal tube in cleft lip and palate surgeries using McGrath Mac videolaryngoscope and Macintosh laryngoscope.  Methods: Sixty children less than 5 years of age, belonging to ASA (American Society of Anesthesiologists) I and II category, who were posted for cleft lip and palate repair were included in the study. They were randomly divided into two groups of 30 each. In group I, Macintosh laryngoscope was used for laryngoscopy and endotracheal intubation and in Group II, McGrath Mac videolaryngoscope was used. Parameters like range of visibility of  vocal cords (Cormack Lehane in Group I vs Fremantle score in Group II), requirement of external laryngeal manipulation (ELM), time taken for intubation and haemodynamic changes were assessed.Results: The time taken for endotracheal intubation was significantly higher in Group II (20.10±2.83s in Group I vs 24.57±3.52s in Group II, p<0.001). Requirement of ELM was significantly higher in Group I (24/30 vs 2/30, p < 0.001). The heart rates recorded at 1 min, 3 mins and 5 mins of laryngoscopy were significantly higher in Group I (139.7±12.06, 128.47±9.1, 119.37±8.96 vs 125.90±12.24, 120.00±8.35 and 113.03±9.76 in Group II respectively). Cormack Lehane gradings were comparable in both the groups. Conclusion: Laryngoscopy with McGrath VL significantly prolongs intubation time compared to conventional Macintosh laryngoscope in cleft lip and palate surgeries. The requirement for external laryngeal manipulation was less with McGrath VL and also less tachycardia was observed with McGrath VL than Macintosh laryngoscope.