Comparison of grooved and conventional Macintosh laryngoscope blades for throat pack insertion: A randomized control trial

Abstract Background and Aims: Throat pack insertion is required for many otolaryngological surgeries under general anesthesia. To facilitate surgery, an oral Ring, Adair, and Elwyn (RAE) endotracheal tube is used. When the Macintosh blade is used to insert the pack, the tube often moves to the left as per its design. We designed a groove in the Macintosh laryngoscope blade to hold the endotracheal tube in place during pack placement. This study was done to compare the grooved and conventional Macintosh laryngoscope blades for throat pack insertion with respect to the intraoral movement of the tube, ease of packing, time taken, and associated hemodynamic changes in patients who have been intubated with a preformed oral endotracheal tube. Material and Methods: This randomized control trial included 80 patients after approval from the institutional ethics committee and CTRI. Informed written consent was taken from all patients. Packing of cases was done with either grooved (group G) or conventional Macintosh laryngoscope blade (group C). Student’s t-test, Chi-square test, and Mann–Whitney U test were used to analyze data. Results: The tube remained in the center in 35/40 patients in group G as compared to 10/40 patients in group C (P < 0.0001). Packing the throat was significantly easier (P = 0.005), and time taken to pack the throat was shorter in group G as compared to group C (P = 0.0008). Conclusions: The endotracheal tube remains in the center more often during throat pack insertion using a grooved laryngoscope blade as compared to the conventional Macintosh laryngoscope blade. The grooved blade is easier to use and takes less time to insert the throat pack.