LARYNGOSCOPY AND LARYNGEAL INTUBATION USING MACINTOSH VERSUS FLEXITIP (TRUPTI) BLADE – RANDOMIZED, PROSPECTIVE STUDY OF A COMPARISON OF THE STRESS RESPONSE, LARYNGOSCOPIC VIEW AND EXTERNAL MANIPULATION

*Dr. Amarjeet D.Patil, Dr. Charu Sudan, Dr. Sunita A.Patil, Dr.Lt.Col. K.R.Sivashankar

ABSTRACT

Background: Laryngoscopy and intubation are known to have profound cardiovascular effects like a pressure response and tachycardia along with an increase in catecholamine concentrations. The major cause of sympathoadrenal response is believed to arise from stimulation of supraglottic region by the Laryngoscope blade and tracheal tube placement and cuff inflation contributing additional stimulation. We studied in a prospective study of a comparison of the stress response, laryngeal view, requirement of the external manipulation(BURP-backward upward rightward pressure) during laryngoscoy and laryngeal intubation, Macintosh versus Flexitip (Trupti) blade. Methods: After obtaining approval from Institutional Ethics Committee and written informed patient consent, 100 ASA I and II patients in the age group 18-60 years of age of either sex, who were normotensive and undergoing planned elective surgery under general anaesthesia were selected in this randomised, prospective study. Data within each group were analyzed using repeated measured analysis of variance and both the group using Chi-square t-test. A „p‟ value of <0.05 was considered significant. Results: Significant difference is noted in hemodynamic parameters in both the groups. Conclusion: To avoid the stress response to laryngoscopy, use of Flexitip (Trupti) blade is a good choice.

Keywords: laryngoscopy, endotracheal intubation, pressor response.