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Abstract Introduction: Endotracheal intubation is the optimal way for airway management. Before tracheal intubation, laryngoscopy must be done on the patient for visualization of glottis, vocal cords and inlet of trachea. If laryngoscopy is done appropriately and airway class has lower score according to Cormack & Lehane classification (C&L), the hemodynamic changes will be low and safe. The laryngoscopes are many kinds but the most common is Macintosh which has two blades standard blade and English blade. In this study we compared these two blades but further investigations are needed for choosing the best blade in different situations. Objective: Comparison the standard blade and English blade of Macintosh laryngoscope in airway classification of elective surgical patients. Materials and Methods: In this clinical trial with replacement interventional study, seventy patients who scheduled for elective surgery and general anesthesia with endotracheal intubation were chosen. They randomly divided to two groups (35 patients in each group) according to series of cards that was written group I or group II standard and English blade. They was chosen with anesthesia nurse after induction of anesthesia and neuromuscular blocking, At first, laryngoscopy was carried out with standard blade then with English blade in group I and with English blade then standard blade in group II. The view of the glottis was graded according to (C&L) classification for each blade during laryngoscopy procedure. ( grade 1 visualizing all parts of glottis and vocal cords, grade 2 only posterior extremity of glottis was visible, grade 3 only epiglottis was seen, grade 4 no recognizable structures. Grade 3 and 4 were considered as difficult laryngoscopy in this study). The trachea was intubated at the second attempt during laryngoscopy procedure. The grading of glottic view were compared, and analyzed with SPSS (V10) and Mc Nemar Test. Results: Among 70 patients, difference in the view of glottis was seen in 15 patients. Lower grade according C&L classification and more complete view of glottis was seen in 13 patients with English blade and 2 patients with Standard blade. There wasn’t seen grade IV of difficult laryngoscopy but grade III of difficult laryngoscopy was seen in 3 patients, the glottis view was more appear in 2 patients with English blade and 1 patient with standard blade. The view of glottis and airway classification base on (C&L) for English blade was: class I in 60 patients (85.7%), class II in 9 patients (12.9%), and this view for standard blade was: class I in 50 patients (71.4%), class II in 18 patients (25.7%). This differences were statistically significant (P= 0.006) between two kind of blades. Conclusion: According to this study, laryngoscopy with English blade of Macintosh provided lower grade of airway and more complete view of glottic opening in comparison with standard blade.

Keywords: Intubation- Intratracheal, Laryngoscopes, laryngoscopy

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* Corresponding Author Address: Alzahra Hospital, Guilan University of Medical Sciences, Rasht, IRAN

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