Anaesthesia
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We report our experience with the McCoy levering laryngoscope in 48 patients who were a Cormack and Lehane grade 3 or grade 4 view at direct laryngoscopy. The view with the blade in neutral position was grade 3 in 39 patients and grade 4 in nine patients. ⋯ The McCoy laryngoscope is a useful tool to aid intubation in about half of patients who are a grade 3 view at laryngoscopy. Our experience indicates it is unlikely to improve a grade 4 view.
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We surveyed members of the Obstetric Anaesthetists Association asking how they tested regional blocks prior to Caesarean section. A large proportion of these anaesthetists appear to test their blocks inadequately. Temperature sensation was the most common sensory modality tested (64%) and 79% of those who tested for temperature sensation used an ethyl chloride spray.
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The McCoy laryngoscope undoubtedly improves the view of the vocal cords during difficult tracheal intubation. An inherent design problem with the McCoy blade is the need to relax the grip on the laryngoscope handle at the point when stability is most necessary. A new hinged tip blade is described which is operated by a button mechanism on a secondary handle that runs adjacent to the standard handle. This modification offers the possibility of better stability and ease of manipulation whilst maintaining all the benefits of the McCoy blade.
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Comment Letter Case Reports
Gum elastic bougie for difficult double-lumen intubation.