A comparison of the stress response to laryngoscopy. The Macintosh versus the McCoy blade

Anaesthesia
E P McCoyB V McCloskey

Abstract

The cardiovascular changes and catecholamine concentrations were compared in 20 patients before and after laryngoscopy with either the Macintosh or the McCoy laryngoscope blades. Following induction with fentanyl and thiopentone and muscle relaxation with vecuronium the vocal cords were visualised for 10 s with either the Macintosh or McCoy blade, chosen at random. Heart rate, arterial blood pressure and plasma noradrenaline and adrenaline concentrations were measured before, and at, laryngoscopy, and 1, 3 and 5 min later. There was a significant increase in both heart rate (33%) and arterial blood pressure (27%) after laryngoscopy using the Macintosh blade (p < 0.01). Use of the McCoy blade did not result in any significant change in either heart rate or arterial blood pressure. There was a slight increase (p > 0.05) in plasma noradrenaline concentrations using the Macintosh blade which persisted for 5 min after laryngoscopy. This was not observed with the McCoy blade. There was no change in plasma adrenaline concentrations with either blade during the 5 min after laryngoscopy when compared to the values before laryngoscopy. It is concluded that the stress response to laryngoscopy is less marked with the use of the McCoy blade...Continue Reading

References

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Citations

Jun 1, 1997·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·T UchidaK Yasuda
Feb 10, 2004·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·E P McCoy
Feb 22, 2012·Journal of Anesthesia·Marco BaciarelloGuido Fanelli
Mar 24, 2000·The Journal of Emergency Medicine·W G Kuschner
Dec 19, 2008·American Journal of Therapeutics·Jamil DarroujRohit Arora
Apr 1, 2006·Simulation in Healthcare : Journal of the Society for Simulation in Healthcare·C Daniel BensonGary E Loyd
Oct 1, 1996·Anaesthesia·T M Cook, J P Tuckey
Oct 26, 2007·Anesthesia and Analgesia·Enrico MonacaFrank Wappler
Jul 24, 2013·Journal of Anaesthesiology, Clinical Pharmacology·Mehtab A Haidry, Fauzia A Khan
Feb 1, 2015·Journal of Clinical Monitoring and Computing·Huseyin TomanMehmet Akif Ovali
Mar 24, 2016·Journal of Anaesthesiology, Clinical Pharmacology·Divya JainKomal Gandhi
May 31, 2017·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·C T WangP W Cheng
Feb 1, 2017·Korean Journal of Critical Care Medicine·Deokkyu KimHyungsun Lim
Mar 8, 2011·Anaesthesia and Intensive Care·P A BakerAustralian and New Zealand College of Anaesthetists

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