AIRWAY CLASSIFICATION

COMPARISON OF STANDARD BLADE VERSUS ENGLISH BLADE OF MACINTOSH LARYNGOSCOPE.

Abstract

Introduction: The optimal way for airway management is endotracheal intubation. Anesthesiologists
use different kinds of laryngoscopes for tracheal intubation, but the most common laryngoscope is Macintosh
laryngoscope with two blades; standard blade and English blade. Objective: Comparison of standard blade and
English blade of Macintosh laryngoscope in airway classification of elective surgical patients. Materials and Methods:
It was a prospective, single blind; clinical trial study that was done on seventy patients's scheduled for elective surgery.
They randomly classified into two groups (I, II). After induction of anesthesia and neuromuscular block in group I
laryngoscopy was done at first with standard blade and then with English blade and in group II laryngoscopy was done
at first with English blade and then standard blade inserted. The view of the glottis at laryngoscopy based on Cormack
and Lehane scores were compared. Results: There was a difference in the view of glottis in 15 patients. Among these
patients the view was better for the English blade in 13 patients and the standard blade was better in 2 patients.
Laryngoscopy was difficult (grade 3) for at least one blade in 3 patients. In these 3 patients, the view was better for the
English blade in 2 patients and for standard blade in 1 patient. The view of glottis as described by Cormack and Lehane
for English blade was Grade I in 60 patients (85.7 %), Grade II in 9 patients (12.9 %), and this view for standard blade
was: Grade I in 50 patients (71.4 %), Grade II in 18 patients (25.7 %). These differences were statistically significant
(P = 0.006) Conclusion: Laryngoscopy with English blade provided a better view on glottis and lower score of Cormack
& Lehane in comparison of standard blade of Macintosh laryngoscope.