Intubation in morbidly obese patients undergoing bariatric surgery: A comparasion of macintosh laryngoscope ve mcgrath® videolaryngoscope

ABSTRACT INTUBATION IN MORBIDLY OBESE PATIENTS UNDERGOING BARIATRIC SURGERY: A COMPARISON OF MACINTOSH LARYNGOSCOPE AND MCGRATH® VIDEOLARYNGOSCOPE Aim: To compare Macintosh laryngoscope and McGrath videolaryngoscope in respect to duration of intubation, haemodynamic response, and complications related intubation in intubation of morbidly obese patients undergoing bariatric surgery; Materials and Methods: Seventy patients with aged 18-65 years old scheduled for bariatric surgery were included in this study. The patients were divided randomly into 2 groups; Macintosh laryngoscope; Macintosh (n = 35), McGrath videolaryngoscope; McGrath (n = 35). Mallampati score, change of head position, intergingival and thyromental distances were recorded. Systolic, diastolic and mean arterial pressures, heart rate, peripheral oxygen saturation, respiratory rate, and end-tidal carbon dioxide values were recorded before anesthesia, after induction, at 1th, 2nd, 3rd and 5th minutes after intubation. Cormack-Lehane score, glottic grade, duration of intubation, laryngeal compression, use of Magill forceps, hemodynamic responses after intubation, use of opioid and complications related intubation were recorded in all cases. Results: The two groups were similar in respect to gender, age, weight, height, body mass index, comorbidity, type of operation, duration of anesthesia and operation. Mallampati score, Cormack Lehanne score and glottic degrees were significantly higher in McGrath. The two groups were similar in terms of thyromental and intergingival distances, change of head position and use of Magill forceps. McGrath significantly had a shorter duration of intubation, higher intervention success in one time and less need for external laryngeal compression. The number of failed intervention was significantly higher in Macintosh. The two groups were similar in respect to use of opioid after intubation, complications related intubation and hemodynamic responses. Conclusion: This study showed that McGrath videolaryngoscope, which has shorter duration of intubation, higher intervention success in one time and less need for external laryngeal compression, is useful for difficult airway management in morbidly obese patients with a high risk of difficult intubation. Keywords: Morbid Obesity, Difficult Airway, Difficult Intubation, Macintosh Laryngoscope, McGrath Videolaryngoscope.