What is it about?
Comparative Study of Haemodynamic Response to Intubation with McCoy laryngoscope, Intubating LMA
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Why is it important?
Laryngoscopy and intubation can result in significant haemodynamic response which is even more exaggerated in hypertensive patients. The magnitude of cardiovascular response is directly related to the force applied and duration of laryngoscopy. Various airway devices and drugs have been tried to limit this pressor response. We conducted a prospective, randomized study to compare haemodynamic response to intubation using McCoy laryngoscope, Intubating Laryngeal Mask Airway (ILMA) and VividTrac® videolaryngoscope in patients with controlled hypertension requiring general anaesthesia for various surgeries. Methods: The study included 90 controlled hypertensive patients of either sex, belonging to ASA grade II, between age group of 40-60 years, requiring general anaesthesia were divided into three groups. In group M, patients were intubated with McCoy laryngoscope. In group L, patients were intubated with intubating LMA. In group V, patients were intubated using VividTrac® videolaryngoscope. Haemodynamic response following intubation were compared among all the three groups. Intubation time, the success rate of intubation and complications, if any, were also compared in all the three groups. Results: It was observed that VividTrac® videolaryngoscope produced significantly less haemodynamic response compared to intubation with ILMA and McCoy laryngoscope. Intubation using McCoy laryngoscope was found to be comparatively a faster method to secure tracheal intubation when compared to ILMA and videolaryngoscope. Complications, like oesophageal intubation and sore throat were more with intubating LMA, whereas injury to oropharyngeal mucosa was found to be observed with VividTrac® videolaryngoscope. Conclusion: VividTrac® videolaryngoscopy and intubation causes less haemodynamic changes compared to Intubating LMA and McCoy laryngoscopy.
Perspectives
Laryngoscopy and intubation can result in significant haemodynamic response which is even more exaggerated in hypertensive patients. The magnitude of cardiovascular response is directly related to the force applied and duration of laryngoscopy. Various airway devices and drugs have been tried to limit this pressor response. We conducted a prospective, randomized study to compare haemodynamic response to intubation using McCoy laryngoscope, Intubating Laryngeal Mask Airway (ILMA) and VividTrac® videolaryngoscope in patients with controlled hypertension requiring general anaesthesia for various surgeries. Methods: The study included 90 controlled hypertensive patients of either sex, belonging to ASA grade II, between age group of 40-60 years, requiring general anaesthesia were divided into three groups. In group M, patients were intubated with McCoy laryngoscope. In group L, patients were intubated with intubating LMA. In group V, patients were intubated using VividTrac® videolaryngoscope. Haemodynamic response following intubation were compared among all the three groups. Intubation time, the success rate of intubation and complications, if any, were also compared in all the three groups. Results: It was observed that VividTrac® videolaryngoscope produced significantly less haemodynamic response compared to intubation with ILMA and McCoy laryngoscope. Intubation using McCoy laryngoscope was found to be comparatively a faster method to secure tracheal intubation when compared to ILMA and videolaryngoscope. Complications, like oesophageal intubation and sore throat were more with intubating LMA, whereas injury to oropharyngeal mucosa was found to be observed with VividTrac® videolaryngoscope. Conclusion: VividTrac® videolaryngoscopy and intubation causes less haemodynamic changes compared to Intubating LMA and McCoy laryngoscopy.
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This page is a summary of: Comparative Study of Haemodynamic Response to Intubation with McCoy laryngoscope, Intubating LMA and Vividtrac® Videolaryngoscope in Controlled Hypertensive Patients, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6419.26.
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