Comparison of Direct Laryngoscopy With McCoy Blade and BPL Video Laryngoscopy for Intubation in Patients Undergoing Elective Cervical Spine Surgery

Background: For patients having cervical spine instability, stabilization of the neck is crucial to prevent further damage to the spinal cord, which can make laryngoscopy challenging. Specialized tools like McCoy blade direct laryngoscope (Surgitech, India) and BPL video laryngoscope (BPL Medical Technologies Pvt. Ltd., India) enhance airway management in these groups of patients. This study compared the efficacy and safety of direct laryngoscopy with McCoy blade and BPL video laryngoscopy in cervical spine surgery patients.

Materials and methods: This randomized prospective comparative study was performed on 60 patients of ASA physical status I & II, either sex, 18 to 65 years of age, undergoing elective cervical spine surgery under general anesthesia. Patients were divided into groups B (BPL) and M (McCoy), with 30 patients in each group. After successful intubation, time for intubation, Modified Cormack Lehane grading, intubation difficulty score, ease of intubation, and hemodynamic parameters were recorded at numerous intervals.

Results: The mean duration for tracheal intubation was longer in Group B (36.30 ± 19.75 seconds) as compared to Group M (28.07 ± 10.19 seconds), which was statistically significant. The MCL grading, in Group B, was 76.67% and in Group M 46.67% of patients achieved MCL grade 1, which was statistically significant (p = 0.049), indicating better visualization of the vocal cords in Group B. Intubation difficulty score, in Group B, was 56.67% patients, and in Group M, only 23.33% patients achieved a score of 0 and it was also statically significant (p=0.042). 86.67% of patients in Group B and 60.00% of patients in Group M had ease of intubation scores 1, which were statistically significant (p = 0.040). All hemodynamic parameters were found statically insignificant in both groups.

Conclusions: This study revealed that BPL video laryngoscopy took more time for intubation but provided better vocal cord visualization and easier intubation, while McCoy blade intubation took less time for tracheal intubation and all hemodynamic parameters remained stable in both groups.