Indian journal of anaesthesia · 2026
Comparison of the standard McCoy laryngoscope and video-assisted McCoy laryngoscope for laryngoscopy and intubation in patients with simulated difficult airway.
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Bansal Teena, Jain Mamta, Kumar Chetan, Singh Anish Kumar, Lal Jatin, Singhal Suresh
Аннотация
BACKGROUND AND AIMS: Video laryngoscopes provide better visualisation of glottis and easier tracheal intubation as compared to the McCoy laryngoscope. However, cost constraints limit their use. The video-assisted McCoy laryngoscope provides the advantage of both, the McCoy laryngoscope and standard video laryngoscope and is cost-effective. The present study was conducted to compare the standard McCoy laryngoscope and video-assisted McCoy laryngoscope in patients with simulated difficult airway.
METHODS: This randomised single-blind crossover study included 60 patients of either gender aged 18 to 65 years. In sequence I (n = 30), 1st laryngoscopy was done with the standard McCoy laryngoscope and the 2nd with the video-assisted McCoy laryngoscope. In sequence II (n = 30), 1st laryngoscopy was done using the video-assisted McCoy and the 2nd with the standard McCoy. Intubation was done after 2nd laryngoscopy in both sequences. The primary objective was grade of glottic visualisation using percentage of glottic opening (POGO) score and modified Cormack Lehane (CL) grade. The secondary objectives were time for glottic visualisation, time for tube insertion, total intubation time, first attempt intubation success, optimisation manoeuvre, and complications. Quantitative variables were compared using t-test, and qualitative variables were compared using Chi-square test and Fisher's exact tests.
RESULTS: Significantly better mean POGO scores [65.66 (27.03)% vs 44.50 (31.59), P < 0.001] and modified CL grades [I/2a/2b/3 in 20/22/16/2 vs 10/19/26/5 patients, P = 0.03] were observed with the video-assisted McCoy laryngoscope. Less time for glottic visualisation, tube insertion, and total time of intubation were observed with the video-assisted McCoy laryngoscope. First attempt intubation success, optimisation manoeuvre, incidence of trauma, and postoperative cough were comparable.
CONCLUSION: The video-assisted McCoy laryngoscope provided significantly better glottic visualisation in patients with simulated difficult airway.
METHODS: This randomised single-blind crossover study included 60 patients of either gender aged 18 to 65 years. In sequence I (n = 30), 1st laryngoscopy was done with the standard McCoy laryngoscope and the 2nd with the video-assisted McCoy laryngoscope. In sequence II (n = 30), 1st laryngoscopy was done using the video-assisted McCoy and the 2nd with the standard McCoy. Intubation was done after 2nd laryngoscopy in both sequences. The primary objective was grade of glottic visualisation using percentage of glottic opening (POGO) score and modified Cormack Lehane (CL) grade. The secondary objectives were time for glottic visualisation, time for tube insertion, total intubation time, first attempt intubation success, optimisation manoeuvre, and complications. Quantitative variables were compared using t-test, and qualitative variables were compared using Chi-square test and Fisher's exact tests.
RESULTS: Significantly better mean POGO scores [65.66 (27.03)% vs 44.50 (31.59), P < 0.001] and modified CL grades [I/2a/2b/3 in 20/22/16/2 vs 10/19/26/5 patients, P = 0.03] were observed with the video-assisted McCoy laryngoscope. Less time for glottic visualisation, tube insertion, and total time of intubation were observed with the video-assisted McCoy laryngoscope. First attempt intubation success, optimisation manoeuvre, incidence of trauma, and postoperative cough were comparable.
CONCLUSION: The video-assisted McCoy laryngoscope provided significantly better glottic visualisation in patients with simulated difficult airway.