Comparative Assessment of Haemodynamic Response to Laryngoscopy and Intubation Using Macintosh Direct Laryngoscope and Video Laryngoscope for Nasotracheal Intubation

Abstract

BACKGROUND Nasotracheal intubation is frequently used for orofacial and ENT surgeries. Greater variations occur in haemodynamics of the patient during nasotracheal intubation. So, in order to find a laryngoscope which will provide better haemodynamic stability, the present study was conducted where changes in haemodynamic parameters were compared between Truview EVO2 video laryngoscope and Macintosh laryngoscope during laryngoscopy and nasotracheal intubation. MATERIALS AND METHODS This is a randomised controlled trial. Sixty adult patients of ASA grade I and II posted for orofacial and ENT surgeries were randomly allocated into two groups depending on the type of laryngoscope used: Group 1 (n= 30)-laryngoscopy with Macintosh blade and Group 2 (n= 30)-laryngoscopy with Truview EVO2 blade. After induction with propofol and succinylcholine, laryngoscopy and nasotracheal intubation was performed according to the group. Haemodynamic variables (HR, SBP, DBP, MAP) were recorded at different time intervals upto 15 minutes duration after intubation. The data was tabulated and statistically analysed. RESULTS As compared to Macintosh laryngoscope, Truview EVO2 video laryngoscope had lesser fluctuations in heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure at 1 and 5 minutes after intubation. CONCLUSION As compared to Macintosh laryngoscope, video laryngoscope provides greater haemodynamic stability during nasotracheal intubation.