Comparison of King Vision Video Laryngoscope with Macintosh Laryngoscope in Patients Requiring Nasal Intubation for Oromaxillofacial Surgery-A Randomised Controlled Study
Correspondence Address :
Dr. Krupa P Patel,
MD Anaesthesiology, Assistant Professor, C/o A 501, Tower No:5 ,Vraj-Nandan Flats,
Near Arya Kanya School, Karelibaug, Vadodara-390018, Gujarat, India.
E-mail: dr.aashish.jain@gmail.com
Introduction: Anaesthesiologists are at constant risk of contracting Coronavirus Disease-2019 (COVID-19) disease. They are constantly conducting surgical procedures despite being surrounded by pandemic. Patients requiring Nasotracheal Intubation (NTI) for oromaxillofacial surgery expose anaesthesiologists to aerosol-risk. Video laryngoscope simplifies NTI with diminished aerosol exposure, decreased time and difficulty for intubation in patients undergoing oromaxillofacial surgery.
Aim:This study was intended to compare the effectiveness of King Vision Video Laryngoscope (KVVL) and Macintosh laryngoscope in patients requiring NTI for oromaxillofacial procedures.
Materials and Methods: This prospective randomised controlled study was conducted on total of 40 patients undergoing oromaxillofacial surgery under general anaesthesia with NTI in Parul Sevashram Hospital, Vadodara, India, from September 2020 to February 2021. Patients were randomly allocated into group KL and group ML of 20 patients each. Laryngoscopy in group KL was performed with KVVL (non channelled blade), while in group ML patients were intubated using Macintosh laryngoscope. Intubation time, Modified Nasointubation Difficulty Scale (MNIDS), haemodynamic parameters, and complications were noted. Student t-test and Chi-square test were used respectively for continuous and categorical variables.
Results: There was no significant difference in the mean age, weight and gender between the groups KL and ML (p-value >0.05).The mean age of the group KL patients were 32.65 years and group ML was 33.95 years which was not statistically significant. Time required for passing tube from glottic opening to trachea (T3) was significantly less (13.5 seconds) in group KL than (17.4 seconds) in group ML (p-value <0.001). A total of 16 patients (80%) and 12 (60%) patients respectively, in group KL and group ML had MNIDS of 0. Increase in Heart Rate (HR) and Mean Arterial Pressure (MAP) was significantly higher in group ML than group KL. Also, a video laryngoscope increases the distance between the operator and airway and hence reduces aerosol exposure.
Conclusion: Intubation time, assist manoeuvre, and change of head position were less in group KL than group ML. KVVL reduces distance between patient and anaesthesiologist. Video laryngoscopes reduce aerosol transmission better than macintosh laryngoscopes. Thus, the video laryngoscopes were found better than macintosh laryngoscopes.
Airway management, Maxillofacial surgery, Nasotracheal intubation
10.7860/JCDR/2021/51620.15618
Date of Submission: Jul 28, 2021
Date of Peer Review: Sep 01, 2021
Date of Acceptance: Sep 30, 2021
Date of Publishing: Nov 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jul 30, 2021
• Manual Googling: Sep 29, 2021
• iThenticate Software: Oct 20, 2021 (15%)
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