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Background and Aims:Literature suggests that glottic view is better when using McGrath® Video laryngoscope and Truview® in comparison with McIntosh blade. The purpose of this study was to evaluate the effectiveness of McGrath Video laryngoscope in comparison with Truview laryngoscope for tracheal intubation in patients with simulated cervical spine injury using manual in-line stabilisation.Methods:This prospective randomised study was undertaken in operation theatre of a tertiary referral centre after approval from the Institutional Review Board. A total of 100 consenting patients presenting for elective surgery requiring tracheal intubation were randomly assigned to undergo intubation using McGrath® Video laryngoscope (n = 50) or Truview® (n = 50) laryngoscope. In all patients, we applied manual-in-line stabilisation of the cervical spine throughout the airway management. Statistical testing was conducted with the statistical package for the social science system version SPSS 17.0. Demographic data, airway assessment and haemodynamics were compared using the Chi-square test. A P < 0.05 was considered significant.Results:The time to successful intubation was less with McGrath video laryngoscope when compared to Truview (30.02 s vs. 38.72 s). However, there was no significant difference between laryngoscopic views obtained in both groups. The number of second intubation attempts required and incidence of complications were negligible with both devices. Success rate of intubation with both devices was 100%. Intubation with McGrath Video laryngoscope caused lesser alterations in haemodynamics.Conclusions:Both laryngoscopes are reliable in case of simulated cervical spine injury using manual-in-line stabilisation with 100% success rate and good glottic view.

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Hypertension and tachycardia have been reported since 1950 during intubation under light anesthesia. Increase in blood pressure and heart rate occurs most commonly from reflex sympathetic discharge in response to laryngotracheal stimulation. Hypertensive response of normal subjects to laryngoscopy and intubation might be enhanced and prove dangerous to hypertensive subjects. Various agents have been used to attenuate hypertensive response. Seventy five patients fulfilling eligibility criteria were included in study. The patients were randomly assigned to one of three groups of twenty five each through a computer generated number. Group A = received 1mg/ kg of esmolol intravenously (n=25), Group B = received 1.5mg/ kg of lidocaine intravenously (n=25), Group C = received 0.2mg/ kg of diltiazem intravenously (n=25). These agents were administered three minutes prior laryngoscopy. Patients were premedicated with fixed dose of injection fortwin and phenergan according to body weight and anesthesia was induced with thiopentone, intubation facilitated by use of succinylcholine. No surgical stimulation, analgesics or inhalational anesthetics were allowed till five minutes after intubation and haemodynamic parameter noted. The results were statistically analyzed. We concluded that esmolol in dose of 1 mg/kg intravenously 3 min prior to laryngoscopy and intubation prevented the rise in heart rate effectively. Esmolol was also effective in attenuating systolic blood pressure increase, diastolic blood pressure increase and increase in mean blood pressure except at 1 min after intubation whereas in comparison lidocaine and diltiazem were not that effective.