Comparative Analysis of Hemodynamic Responses and Perfusion Index during Tracheal Intubation Using Macintosh and McCoy Laryngoscopes

Abstract

Background: Tracheal intubation, a cornerstone of airway management during general anaesthesia, is associated with transient but significant hemodynamic responses. The type of laryngoscope used can influence the magnitude of this response.

Aim: To compare the hemodynamic parameters and perfusion index (PI) following tracheal intubation with Macintosh and McCoy laryngoscopes.

Methods: Sixty patients aged 20–40 years with ASA I–II status undergoing elective surgeries under general anaesthesia were randomized into two groups (n=30 each) for intubation using either a Macintosh or McCoy laryngoscope. Hemodynamic variables—heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and PI—were measured at baseline, during, and after intubation.

Results: No significant differences in baseline demographics or ASA status were observed between groups. Post-intubation HR, BP, and PI values showed variations within both groups; however, the McCoy group exhibited comparatively lower hemodynamic fluctuations and a more stable perfusion index.

Conclusion: Macintosh and McCoy laryngoscopes demonstrated comparable performance in terms of hemodynamic stability and perfusion index changes during intubation in ASA I–II patients. While McCoy is hypothesized to reduce sympathetic stimulation, our findings suggest either device may be used without significant difference in low-risk patients.