ABSTRACT : To determine whether use of Mc coy blade results in meaningful reduction in the hemodynamic response to laryngoscopy

METHODS : One hundred consecutive patients who underwent surgery under general anesthesia in LTMMC hospital, Mumbai were prospectively included in the study. Each patient underwent detailed pre anesthetic check up. Those with difficult mask ventilation / intubation, pathology in neck, morbid obesity and ASA 3 status were excluded. In odd numbered patients McIntosh [MCI] blade was used whereas in even numbered patients, Mc coy [MCC] blade was used. Median age, ASA score and mallampatti grading were comparable between the two groups. Median baseline pulse was 90/min, systolic BP [SBP] was 120 mmHg and diastolic BP [DBP] was 76 mm Hg in both the groups.

RESULTS : Median laryngoscopy time was 20 min for MCI and 16 min for MCC. At 1 min, median raise in pulse/SBP/DBP was 11 vs 8 per minute, 20 vs 8 mmHg and 10 vs 4 mmHg for MCI and MCC respectively. At 10 min, median pulse/SBP/DBP was 92 vs 88 per min, 130 vs 126 mmHg and 80 vs 76 mmHg for MCI and MCC respectively. In the MCI group, 34% patients required BURP compared to none in the MCC group. Complications developed in 6% patients in MCI group compared to none in MCC group.

CONCLUSIONS : Laryngoscopy using Mc coy blade leads to lesser hemodynamic response and fewer complications than McIntosh blade and hence is preferred in high risk individuals who may not tolerate significant hemodynamic changes during laryngoscopy.