Journal of Anaesthesiology Clinical Pharmacology

LETTERS TO EDITOR
Year
: 2019  |  Volume : 35  |  Issue : 3  |  Page : 406--407

McCoy Laryngoscope: A savior in patient with limited mouth opening


Teena Bansal, Susheela Taxak, Aruna Yadav, Somesh Singh 
 Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India

Correspondence Address:
Dr. Teena Bansal
19/6 J, Medical Campus, PGIMS, Rohtak, Haryana - 124 001
India




How to cite this article:
Bansal T, Taxak S, Yadav A, Singh S. McCoy Laryngoscope: A savior in patient with limited mouth opening.J Anaesthesiol Clin Pharmacol 2019;35:406-407


How to cite this URL:
Bansal T, Taxak S, Yadav A, Singh S. McCoy Laryngoscope: A savior in patient with limited mouth opening. J Anaesthesiol Clin Pharmacol [serial online] 2019 [cited 2019 Dec 10 ];35:406-407
Available from: http://www.joacp.org/text.asp?2019/35/3/406/265905


Full Text



McCoy blade is known to help in difficult intubation by lifting difficult to lift epiglottis but not for limited mouth opening. We found this blade useful for limited mouth opening as well. A 30-year male of road side accident was posted for surgery of fracture clavicle with mouth opening 2 cm due to fracture of zygomatic arch and maxilla. We decided to perform check laryngoscopy under topical anesthesia of the airway. With the limited interincisor gap of 2 cm, we were not sure whether we will be able to insert any of our available laryngoscope blades (Macintosh and McCoy) as the cut-off of interincisor gap is 3 cm. So, we carried out a thorough measurement of both the blades and found that the McCoy blade (Penlon manufacturer) was sleeker than the Macintosh blade (Penlon manufacturer; 1.6 cm of Macintosh versus 1.2 cm of McCoy at tip and 2.2 cm of Macintosh versus 1.5 cm of McCoy at handle side) [Figure 1] and [Figure 2]; and thus, we decided to try check laryngoscopy with McCoy blade.{Figure 1}{Figure 2}

Airway was anesthetized with 10% lignocain spray (five puffs over 1 min). McCoy blade could be inserted with ease and the epiglottis could be visualized and lifted with gentle traction and only slight discomfort to the patient. Injection glycopyrrolate and fentanyl were administered intravenously (IV) and patient was anesthetized with IV propofol. After check ventilation, succinylcholine was given. Laryngoscopy was done with McCoy Laryngoscope and grade II Cormack–Lehane was observed and trachea was intubated successfully.

McCoy laryngoscope is used in patients when difficulty in elevating epiglottis is encountered and activation of blade tip elevates the epiglottis and visualization of vocal cords.[1] We used it because of limited mouth opening after realizing that it is 4 mm sleeker than the Macintosh blade at the tip and 7 mm at the handle end. We looked up the literature to find out if this is true for all brands of these blades, but it is not mentioned in literature.

We wish to highlight that McCoy blade can bring down the cut-off for intercisor gap needed for successful intubation and can serve as a boon in patients with limited mouth opening. It may be worth measuring the dimensions of all your laryngoscope blades, and especially the McCoy blades while planning to manage the airway of a patient with limited mouth opening.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1McCoy E. The McCoy laryngoscope. Anaesthesia 1996;51:990.