COMPARISON OF INTUBATION CHARACTERISTICS OF KING VISION VIDEO LARYNGOSCOPE VS C-MAC VIDEOLARYNGOSCOPE FOR NASOTRACHEAL INTUBATION – A RANDOMISED CONTROLLED STUDY

Nasotracheal intubation is essential to provide surgical access in patients who are undergoing oral and maxillofacial surgeries. Nasotracheal intubation is more challenging than orotracheal intubation due to the difficulty in advancing the tip of the endotracheal tube into the trachea.Video laryngoscopes aid in visualisation of the vocal cords without the need to align the oral, pharyngeal, and tracheal axes hence facilitating intubation. This study will be done to compare C-MAC D-blade video laryngoscope to non-channelled King Vision video laryngoscope for nasotracheal intubation. This study will include 86 ASA -1 and ASA-2 patients aged between 18 to 59 years undergoing maxillofacial or oral cavity surgery requiring nasotracheal intubation. Patients will be divided into 2 groups (43 each) randomly via computer generated sequence. A detailed preanesthetic evaluation and all the relevant investigations will be done. On arrival in OT, standard ASA monitors will be attached and all patients will be premedicated using 0.02 mg/kg midazolam, 0.2mg glycopyrrolate, 4mg ondansetron and 2mcg/kg fentanyl intravenously. All the patients will be preoxygenated with 100% oxygen for 3 minutes. Standard induction will be with Inj. Propofol 1.5-2mg/kg intravenously and Inj. Atracurium 0.5 mg/kg intravenously for muscle relaxation. Isoflurane will be used as the inhalational agent. Nasotracheal intubation will be performed with appropriately sized RAE(Ring-Adair-Elwin) endotracheal tube by an experienced anaesthesiologist.The primary outcome variable will be total intubation time calculated from the beginning of introduction of the RAE endotracheal tube in the nostril till the appearance of the first end‑tidal carbon dioxide waveform(capnography). This will include time required for insertion of the ETT in each of three intubation steps (from nose into oropharynx(T1), from oropharynx into glottic inlet(T2), and from glottic inlet to observation of first capnographic trace(T3)). The time taken will be noted by the Primary investigator using a stopwatch. The secondary outcomes will be comparing glottic view as percentage of glottis opening (POGO) score, modified nasal intubation difficulty score (NIDS) and complications related to NTI. Data collected will be collected and will be tabulated for statistical analysis.