Title: Comparative evaluation of King Vision Video laryngoscope and McCoy laryngoscope for tracheal intubation in patients with immobilized cervical spine: a prospective randomized study

Authors: Dr Pasupunuri Sharath Chandra, Dr Sarfaraz Ahmad, Dr Gopal Krishan, Dr Rampal Singh, Dr Malti Agarwal, Dr Kaustab Singh

 DOI: https://dx.doi.org/10.18535/jmscr/v8i11.53

Abstract

Background and Aims: It is challenging even to the most experienced anaesthesiologist to intubate in patients with restricted movement of the cervical spine. The randomized studies comparing King Vision video laryngoscope and McCoy laryngoscope are very limited. Therefore, we planned to study a comparative evaluation of King Vision video laryngoscope and McCoy laryngoscope for tracheal intubation in patients with immobilized cervical spine

Method: This was a prospective randomized study, carried out in patients posted for elective surgery.60 patients were randomly divided in two groups comprising 30 patients each of ASA Grade I or II , age 18-60yrs, either sex and weighing 45-80 kg under General Anaesthesia. Induction was done with inj. propofol 2.0 mg kg-1/iv and inj. succinylcholine 1.5 mg kg-1 /iv were used as muscle relaxant and Intubation was done using/applying standard protocol/technique with either King Vision video laryngoscope or McCoy laryngoscope.

Result: The demographic variables such as age, sex and ASA were similar in both the groups. There was no statistically significant difference. Mean intubation time of patients in Group A was 16.9 ± 3.5 sec and in Group B was 19.3 ± 5.1 sec. The mean intubation time was less in Group A patients and was statistically significant (p = 0.021). There was a statistically significant difference in POGO score of patients in between Group A and Group B (p<0.001). There was no statistically significant difference in IDS of patients in between Group A and Group B (p=0.077). The mean arterial pressure was better in Group A although, there was no statistically significant difference.

Conclusion: We conclude that the King Vision video Laryngoscope is superior to the McCoy   laryngoscope if cervical immobilization is anticipated.

References

  1. Ahmed SM, Ajmal PM, Ali S and Athar M. A Comparative Evaluation of C-MAC Video Laryngoscope and King Vision Video Laryngoscope in Patients Undergoing Tracheal Intubation with Cervical Spine Immobilization: A Prospective Randomized Study. Austin J Anesthesia and Analgesia. 2018; 6(1): 1066.
  2. Apfelbaum JL, Hagberg CA, Caplan RA, Blitt CD, Connis RT, Nickinovich DG, Benumof JL, Berry FA, Bode RH, Cheney FW, Guidry OF. Practice guidelines for management of the difficult airwayan updated report by the American Society of Anesthesiologists task force on management of the difficult airway. The Journal of the American Society of Anesthesiologists. 2013 Feb 1;118(2):251-70.
  3. Goutcher CM, Lochhead V. Reduction in mouth opening with semi-rigid cervical collars. British journal of anaesthesia. 2005 Sep 1;95(3):344-8.
  4. Heath KJ. The effect on laryngoscopy of different cervical spine immobilization techniques.Anaesthesia. 1994 Oct;49(10):843-5.
  5. Uchida T, Hikawa Y, Saito Y, Yasuda K. The McCoy levering laryngoscope in patients with limited neck extension.Canadian Journal of Anaesthesia. 1997 Jun 1;44(6):674-6.
  6. Biswal D, Pradhan BK, Hari Shankar R. A Comparative Evaluation of the Hemodynamic Response and Ease of Intubation with King Vision Video Laryngoscope and Mccoy Laryngoscope in Patients Posted For Cervical Spine Surgery, Undergoing Tracheal Intubation for General Anaesthesia. Sch. J. App. Med. Sci., Mar 2018; 6(3): 1257-1263
  7. Shravanalakshmi D, Bidkar PU, Narmadalakshmi K, Lata S, Mishra SK, Adinarayanan S. Comparison of intubation success and glottic visualization using King Vision and C-MAC videolaryngoscopes in patients with cervical spine injuries with cervical immobilization: A randomized clinical trial. Surgical neurology international. 2017;8.
  8. Ahmad S, Ali QE, Jamal MK, Kamal S, Pal K. A Prospective Randomized Study to Compare and Evaluate King Vision Video Laryngoscope and McCoy Laryngoscope as Intubating Devices in Adult Patients. J Med Sci Clin Res. 2017 Mar 26;5(03):19319-26
  9. Ali Q, Amir SH, Ahmed S. A comparative evaluation of King Vision video laryngoscope (channelled blade), McCoy, and Macintosh laryngoscopes for tracheal intubation in patients with immobilized cervical spine. Sri Lankan Journal of Anaesthesiology. 2017 Jul 5;25(2).
  10. Singhal V, Bhandari G, Shahi KS, Chand G. Comparative Study of Mccoy, Airtraq and King’s Vision Videolaryngoscope in Simulated Difficult Laryngoscopy Using Rigid Neck Collar. Ann. Int. Med. Den. Res. 2020; 6(4):AN05-AN09.

Corresponding Author

Dr Sarfaraz Ahmad

Assistant Professor, Department of Anaesthesiology, Rohilkhand Medical College, Bareilly