BACKGROUND:McCoy laryngoscope incorporates a modification of the Macintosh laryngoscope. It was designed to facilitate difficult intubation. Use of this blade reduces the lifting force required during laryngoscopy. MATERIAL AND METHODS: The present prospective randomized study was conducted to evaluate the effectiveness of McCoy laryngoscope in attenuating the pressor response secondary to tracheal intubation as compared to Macintosh laryngoscope in terms of magnitude and duration in 80 patients of ASA Grade I and II. The changes in heart rate, systolic, diastolic, mean arterial pressure and rate pressure product were observed for 10 minutes post intubation. Time taken for laryngoscopy and intubation was also noted. RESULTS: Following laryngoscopy and intubation, it was observed that there was statistically significant rise in heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product in both the groups. The increase in hemodynamic variables was statistically significant with Macintosh laryngoscope as compared to McCoy laryngoscope and lasted for lesser duration in McCoy group. CONCLUSION: McCoy laryngoscope produces significantly less marked hemodynamic response as compared to Macintosh laryngoscope.

Peri-operative pain management in the neonate with a sacrococcygeal teratoma poses significant challenges to the anaesthetist. Involvement of the sacrococcygeal area by the tumour often prevents the use of conventional regional anaesthetic techniques such as caudal or epidural analgesia, with a subsequent reliance on intravenous opioids and paracetamol. Since opioids are associated with respiratory depression, constipation and urinary retention, there is high incidence of opiophobia with consequent inappropriate dosage prescription, particularly in the paediatric population. We describe the use of an ultrasound-guided sacral multifidus plane block in two neonates undergoing surgical excision of sacrococcygeal teratoma. The block is technically easy to perform and also avoids traversing critical structures. Hence, it may be regarded as a promising analgesic technique for painful interventions in the sacrococcygeal area.