ABSTRACT : The objective of this study were to compare the intubating conditions in adult surgical patients using video laryngoscope with macintosh laryngoscope with respect to ease of intubation, time taken for intubation, airway trauma and hemodynamic response to laryngoscopy

METHODS : In a single centre, prospective, randomized, parallel group, open lable, interventional study, 40 adults patients patients posted for surgery under general anaesthesia need of endotracheal intubation were recruited and allocated in to two group: Group A (n=20) intubated with videolaryngoscope and Group B (n-20) intubated with conventional macintosh laryngoscope in standard intravenous induction. The primary outcome measure was ease of intubation which was assessed by intubation difficulty score and secondary outcome measures like intubation time, airway trauma and hemodynamic parameters for laryngoscopy in every 2 minutes for 10 minutes before and after intubaton were assessed.

RESULTS : Three patients in the videolaryngoscope group had an Total IDS of more than 1, whereas 10 patients in the Macintosh group had an Total IDS of 1 or greater. In the Macintosh group, 4 patients had an Total IDS of 5 or greater, indicating moderate to severe intubation difficulty, whereas no patient in the videolaryngoscope group had an Total IDS of more than 3.( p-0.0011). Mean duration of intubation with the videolaryngoscope group was 15.93 secs whereas in the Macintosh group it was found to be 38.70 secs (p-0.0001). The increase in mean heart rate from the pre induction to post intubation in videolaryngoscope group was 20.9 per min whereas in macintosh group was 31.9 per min. The increase in mean MAP from pre intubation to post intubation in videolaryngoscope group was 12.6mmHg whereas in macintosh group was 30.3 mmHg. The differences in heart rate, and blood pressure except diastolic BP in both the groups was statistically significant in the post intubation ( 4th min) measurements, statistically signigicant difference in systolic BP at 6th mins (p<0.05)and not statistically significant difference in the 8th and 10th post intubation measurement..The SPO2 changes in the pre and post intubation periods in both the groups was not statistically significant(p<0.05). 3 patients in the Macintosh group and 2 patients in the videolaryngoscope group experienced trauma to the airways(p-0.958)

CONCLUSIONS : Study concluded that endotracheal intubation is easier, less time taken for intubation , less trauma and less hemodynamic response when using videolaryngoscope than macintosh laryngoscope. videolaryngoscope significantly improve the view of glottic opening and facilitates fast, easy and reliable intubation. It can also be useful in routine anaesthesia management , in critical care, anticipated , unanticipated airway situations, neuro and cardiac patients due to less hemodynamic response