A COMPARATIVE STUDY OF PAEDIATRIC C-MAC VIDEO LARYNGOSCOPE AND MACINTOSH DIRECT LARYNGOSCOPE FOR ENDOTRACHEAL INTUBATION IN PAEDIATRIC PATIENTS POSTED FOR ELECTIVE SURGERY UNDER GENERAL ANAESTHESIA.

Airwaymanagement is a fundamental procedural skill for practice of generalanaesthesia. In most cases, orotracheal intubation is done by directlaryngoscopy, in which a conventional laryngoscope is used to establish adirect line of sight from the laryngoscopist through the patient’s mouth to theglottic opening.[1]

 Inrecent years video laryngoscopy has played an important role in the managementof patients with unanticipated difficult or failed endotracheal intubation.Video laryngoscopy is a term used for techniques applied to intubation inwhich the glottis opening is visualized indirectly over the monitor screen,allowing the laryngoscopist to place an endotracheal tube without seeing thelarynx directly. Different videolaryngoscopes are available with combineddirect/indirect glottic view (C-MAC, Karl Storz, Tuttlingen, Germany) as wellas obligate indirect glottic view (e.g., GlideScope, McGrath videolaryngoscope), depending on the blade.[2]

 Routineairway management and a detailed handling of the expected and unexpected airwaydifficulty are the specific concerns for anaesthesiologists. A combineddirect/indirect laryngoscopy may hence be preferred.[3]

 Thechallenges faced in the management of paediatric airway are based on anatomicaldifferences from adults. The prediction of difficult airway is not feasible inchild because measurement of mentohyoid, thyromental and inter-incisior lengthsare not validated.[4]

 Incomparison with adults, physiological variation like higher oxygen consumptionleads to early desaturation during tracheal intubation, thus highlighting theimportance of time taken for intubation in paediatric patients. Failure tosecure the airway remains the leading cause for morbidity and mortality in theoperative and ICU emergency setting.

 Comparedto direct laryngoscopy, video laryngoscopes are preferred lately as theyprovide a better glottic view with minimum manipulation of neck, airway andlarynx. In spite of the better view the maneuvering of  the endotracheal tube is difficult because itrequires higher level of hand eye co-ordination.[4]

 Thisstudy intends to compare the Paediatric C-MAC Video laryngoscopy withconventional Macintosh laryngoscopy in Indian paediatric population.