Mac Doshi laryngoscope blade makes tracheal cuff protection easier during double-lumen tube placement

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Abstract

Introduction
Tracheal cuff rupture is a known complication during double-lumen tube (DLT) placement. Mac Doshi laryngoscope blade has an increased height of web. On account of its wider web, it provides a wider mouth opening and easier movement of the tongue to the left side. We hypothesized that this wider web should act as a guard and prevent brushing of tracheal cuff over teeth.
Aims and objectives
We designed this study to evaluate the usefulness of Mac Doshi laryngoscope blade for ease of tracheal cuff protection during DLT placement.
Patients and methods
After approval from the Institute Ethical Committee, 60 consenting patients of either sex with American Society of Anesthesiologists physical status II or III and scheduled for cardiac and thoracic procedures under general anaesthesia with DLT placement were recruited for this study. Patients were randomized with a computer-generated random number table and assigned to either of the two groups. In group 1, DLT placement was performed with Macintosh laryngoscope blade. In group 2, DLT placement was performed with Mac Doshi laryngoscope blade. Outcome parameters were incidence of tracheal cuff rupture and score given by physician for ease of tracheal cuff protection during DLT placement on Likert score for measure of agreement.
Results
The median score and interquartile range was 2 (2–4) in Macintosh versus 1.5 (1–2) in the Mac Doshi group. This difference was statistically significant (P=0.02). There was one case of tracheal cuff rupture in the Macintosh group and none in the Mac Doshi group.
Conclusion
Mac Doshi laryngoscope blade makes favourable condition for tracheal cuff protection during DLT placement.

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