Background and Aims:C-MAC® video laryngoscope (VL) with Macintosh blade has been found to improve Cormack-Lehane (C-L) laryngoscopic view as well as intubating conditions for orotracheal intubation. However, studies done on the performance of C-MAC® VL for nasotracheal intubation (NTI) are very few in number. Hence, we compared laryngoscopy and intubating conditions between Macintosh direct laryngoscope and C-MAC® VL for NTI.Methods:Sixty American Society of Anesthesiologists Physical Status I, II patients, aged 8–18 years, posted for tonsillectomy surgeries under general anaesthesia with NTI were randomised, into two groups. Patients in group 1 were intubated using Macintosh direct laryngoscope and group 2 with C-MAC® VL. C-L grading, time required for intubation, need for additional manoeuvres and haemodynamic changes during and after intubation were compared between the groups.Results:C-L grade 1 views were obtained in 26 and 29 patients in group 1 and group 2, respectively (86.7% vs. 96.7%). Remaining patients were having C-L grade 2 (13.3% vs. 3.3%). Duration of intubation was less than a minute in group 2 (93.3%). Need for additional manoeuvres (M1–M5) were more in group 1 (97% vs. 77%). M1 (external manipulation) was needed more in group 2 compared to group 1 (53.3% vs. 30%). Magill's forceps alone (M4) and M4 with additional external manipulation (M5) were needed more in group 1 compared to group 2 (60% vs. 16%).Conclusion:The overall performance of C-MAC® VL was better when compared to conventional direct Macintosh laryngoscope during NTI in terms of glottis visualisation, intubation time and need for additional manoeuvres.
BACKGROUND AND OBJECTIVEPreoperative evaluation is important in the detection of patients at risk for difficult tracheal intubation. The purpose of the present study was to evaluate and compare the accuracies of the Ratio of Patient's Height to TMD (Ratio of height to TMD = RHTMD), with TMD and Modified Mallampati classification (MP) in the prediction of difficult tracheal intubation.
To compare the effect of 30ml of 0.5% bupivacaine and 30ml of 0.75% ropivacaine in supraclavicular brachial plexus block with respect to onset time of sensory blockade, onset time of motor blockade, duration of sensory blockade, duration of motor blockade, duration of analgesia and any side effects. MATERIALS AND METHODS Sixty patients of ASA-I and II undergoing elective upper limb surgeries lasting more than 30 minutes were randomly divided into Group B and Group R, which received 30ml of 0.5% bupivacaine and 0.75% ropivacaine respectively. Sensory and motor block onset and duration and duration of analgesia were evaluated statistically using unpaired t-test and p-value <0.05 was considered significant. RESULTS The onset time of sensory block was faster in Group R compared to Group B having a mean value of 16.13±3.05 minutes and 17.70±2.35 minutes respectively. The onset time of motor block was faster in Group R compared to Group B having a mean value of 23.90±1.83 minutes and 25.43±2.22 minutes respectively. The duration of sensory and motor block (Mean-minutes) was 480.3 and 472.8 in group R and 472.1 and 460.2 in group B. The duration of post-operative analgesia was 504.2 minutes in Group R and 499.6 minutes in Group B. CONCLUSION Group R provided statistically significant rapid onset of sensory and motor blockade, prolonged duration of both sensory and motor blockade, prolonged duration of analgesia than Group B for upper limb surgeries. There were no significant differences in haemodynamic changes and complications.
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