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October 19, 2008
9:00 AM - 11:00 AM
Room Hall E2-Area G,
Rusch Truview Evo-2 Is a Superior Aid to Tracheal Intubation in Patients with Difficult Airway
Mohammad Maroof*, M.D., F.R.C.A., Rashid Khan, M.D., Yasir Khan, M.D., Fauzia R. Khan, M.D., Baseer M. Maroof
Anesthesiology, J.N.Medical College, AMU, Aligarh & UNC, Chapel Hill, NC
Introduction: A complete glottic view is rarely observed with a conventional rigid Macintosh laryngoscopy (ML) in patients with difficult airways. The RuschTruview Evo-2 laryngoscope (TEL) is a recently introduced modified laryngoscope which incorporates an unmagnified optic side with prism to its special blade. This configuration provides a 42º additional anterior view. It was hypothesized that the TEL would enhance glottis visualization where the conventional ML provided minimal viewing capabilities. .

Methods: This is two part cross over study. In part one all patients with difficult airway predictors presenting for GA were selected for this. Informed consent was obtained.

Following a uniform premedication and induction with either inhalation or slow propofol injection mask ventilation was established. After relaxation with succinylcholine 0.75mg/kg, ML was attempted and POGO scoring1 and Cormack & Lehanne's grade noted. Thereafter, laryngoscopy was performed with TEL and patient intubated after noting POGO score & Cormack & Lehanne's grade.

Second part of study consisted of patients who were not able to be intubated with macintosh or miller blades were attempted to intubate with TEL. We had 15 failed intubations with conventional laryngoscopy with a POGO of 0, all were intubated with TEL with a POGO of 50-100%.[table1]Results: The breakdown of the patients was as follows in group:

Morbidly obese patient, Restricted mouth opening <2.5 cm, Postburn contracture of face & neck, Limited mouth opening & head extension, receding mandible, Cervical Fracture with Collar in place, Ludwig Angina with non-compliant submandibular, Buck teeth space.[figure1]

Anesthesiology 2008; 109 A524
GroupsMallampati gradePOGO score with ML LaryngoscopePOGO Score with TEL LaryngoscopeCormack & Lehanne's grade with TELIntubation
Study I2.5±0.95±9.387±18*1.1±0.4*Obtained with TEL
*p <0.05
Figure 1