EVALUATION OF NASOTRACHEAL INTUBATION WITHVIDEOLARYNGOSCOPE (TUORENTM) AND MACINTOSHDIRECT LARYNGOSCOPE – A PROSPECTIVE RANDOMISEDCOMPARATIVE STUDY
Main Article Content
Keywords
Nasotracheal Intubation, Videolaryngoscope, Macintosh Direct Laryngoscope, Time to intubation, Hemodynamics
Abstract
Background: Nasotracheal intubation (NTI) is a common method for securing the airway during
head and neck surgeries. This study was undertaken to compare NTI with videolaryngoscope
(TuorenTM) and Macintosh direct laryngoscope in patients undergoing elective surgeries under general anaesthesia (GA) with NTI.
Method: Exclusion criteria were difficult mask ventilation or tracheal intubation, history of
respiratory insufficiency and nasal pathology. Taking minimum required sample size for 80% power
of study and 5% level of significance, 25 patients were included in each study group : Group D
(Macintosh direct laryngoscope) or Group V (Videolaryngoscope).
Formula used for comparing mean of two groups was: N >= 2(standard deviation) 2X (Zα+Zβ)2
(mean difference)2 (Where Zα is value of Z at two sided alpha error of 5%, Zβ is value of Z at power of 80% and mean difference is difference in mean values of two groups) Time to intubation, number of attempts, ease of insertion of endotracheal tube (ETT), use of Magill’s forceps, any ETT cuff tear and hemodynamic parameters at intubation were compared. For statistical analysis, SPSS version 25.0 was used with Independent t test, Chi-Square and Fisher’s Exact test. A p value of less than 0.05 was considered significant.
Results: Demographic profile, time to intubation, number of attempts and cuff tear between the
groups were comparable. Group V was better regarding ease of insertion, use of Magill’s forceps and hemodynamic response.
Conclusion: Videolaryngoscope (TuorenTM) is better than the Macintosh direct laryngoscope for
ease of NTI and hemodynamic response during NTI.
References
2. Chauhan V, Acharya G. 2016;20:662-7 : Nasal intubation: A comprehensive review.. Indian J Crit Care Med . 2016, 20:662-7. 10.4103/0972-5229.194013
3. King BJ, Padnos I, Mancuso K, Christensen BJ. : Comparing Video and Direct Laryngoscopy for Nasotracheal Intubation.. Anesth Prog.. 2020, 67:193-9. 10.2344/anpr-67-02-08
4. Levitan RM, Hagberg CA. : Upper airway retraction: New and old laryngoscope blades. Benumof and Hagberg's Airway Management. Hagberg CA (ed): Elsevier, Philadelphia; 2012. 10.1016/B978-1-4377-2764-7.00024-5
5. Haidry MA, Khan FA. : Comparison of hemodynamic response to tracheal intubation with Macintosh and McCoy Laryngoscopes. . J Anesthesiol Clin Pharma . 2013, 29:196-9. 10.4103/0970-9185.111710
6. Thamboo A, Velasquez N, Habib AR, Zarabanda D, Paknezhad H, Nayak JV. : Defining surgical criteria for empty nose syndrome: validation of the office-based cotton test and clinical interpretability of the validated empty nose syndrome 6-item questionnaire. . Laryngoscope. 2017, 127:1746-52. 10.1002/lary.26549
7. Likert R: A technique for the measurement of attitudes.. Arch Psychol . 1932, 140:55.
8. Aggarwal H, Kaur S, Baghla N, Kaur S. : Hemodynamic response to orotracheal intubation: Comparison between Macintosh, McCoy, and C-MAC video laryngoscope. . Anesth Essays Res. 2019, 13:308-12. 10.4103/aer.AER_7_19
9. Kumari M, Aastha, Kumari A, Bathla S, Sabharwal N, Das AK. : Comparative Evaluation of C-MAC Videolaryngoscope with Macintosh Direct Laryngoscope in Patients with Normal Airway Predictors . Anesth Essays Res. 2022, 16:326-30. 10.4103/aer.aer_78_22
10. Buhari FS, Selvaraj V. : Randomized controlled study comparing the hemodynamic response to laryngoscopy and endotracheal intubation with McCoy, Macintosh, and C- MAC laryngoscopes in adult patients.. J Anaesthesiol Clin Pharmacol. 2016, 32:505-9. 10.4103/0970-9185.194766
11. Wayne MA, McDonnell M. : Comparison of traditional versus video laryngoscopy in out-of-hospital tracheal intubation.. Prehos Emerg Care. 2010, 14:278-82. 10.3109/10903120903537189
12. Tseng KY, Lu IC, Shen YC, Lin CH, Chen PN, Cheng KI. : A comparison of the video laryngoscopes with Macintosh laryngoscope for nasotracheal intubation.. Asian J Anesthesiol. 2017, 55:17-21. 10.1016/j.aja.2017.05.006
13.Lewis SR, Butler AR, Parker J, Cook TM, Schofield-Robinson OJ, Smith AF : Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation: a Cochrane Systematic Review. Br J Anaesth. 2017, 119:369-83. 10.1093/bja/aex228
14.Heuer JF, Heitmann S, Crozier TA, Bleckmann A, Quintel M, Russo SG : A comparison between the GlideScope® classic and GlideScope® direct video laryngoscopes and direct laryngoscopy for nasotracheal intubation. J Clin Anesth. 2016, 33:330-6. 10.1016/j.jclinane.2016.04.022
15. Kwak HJ, Lee SY, Lee SY, Cho SH, Kim HS, Kim JY : McGrath video laryngoscopy facilitates routine nasotracheal intubation in patients undergoing oral and maxillofacial surgery: a comparison with Macintosh laryngoscopy. J Oral Maxillofac Surg. 2016, 74:256-61. 10.1016/j.joms.2015.07.021
16. Kasaudhan S, Gupta M, Singh K, Khan A : A comparison of intubating conditions for nasotracheal intubation with standard direct Macintosh laryngoscope versus C- MAC® video laryngoscope employing cuff inflation technique in adult patients. Indian J Anaesth. 2021, 65:S104-S109. 10.4103/ija.IJA_236_21
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Upasana Goswami
MD, DNB (Anesthesiology), Specialist , Dept of Anesthesiology, Deen Dayal Upadhyay Hospital, New Delhi
Dr Sachin Gupta
DNB (Anesthesiology), Senior Resident , Dept of Anesthesiology, Deen Dayal Upadhyay Hospital, New Delhi
Dr Gitanjali Bugnait
HOD, Dept of ENT, Deen Dayal Upadhyay Hospital, New Delhi
Dr Puneet Dwivedi
CMO, Dept of Anesthesiology, Deen Dayal Upadhyay Hospital, New Delhi