Comparison of hemodynamic responses to laryngoscopy and orotracheal intubation between Macintosh laryngoscope and king vision video laryngoscope in adult surgical patients

Abstract

Introduction and Objectives: Endotracheal intubation involving conventional laryngoscopy elicits a hemodynamic stress response which can be deleterious in susceptible individuals. The study was aimed to see if King Vision video laryngoscope has any advantages over conventional Macintosh laryngoscope in attenuating the hemodynamic response during endotracheal intubation. Materials and Methods: 80 ASA I and II patients (aged 18-59 years) who fit the eligibility criteria and scheduled for elective surgery under general anesthesia were recruited for the study after obtaining permission from the institutional review board. By randomization they were allocated into two groups. Group A underwent intubation with King Vision video laryngoscope (KVVL) and group B were intubated with Macintosh laryngoscope (MDL). Systolic BP, diastolic BP, mean arterial pressure, heart rate and Sp02 were measured at baseline, post induction, prelaryngoscopy and post intubation at 1, 3 and 5 minutes. The time duration for intubation, numbers of attempts for intubation and postoperative pharyngeal morbidities were also noted. Results: The duration of laryngoscopy and intubation was significantly longer in group A (KVVL) when compared to group B (MDL) patients (18.28 ± 6.555 Vs. 14.75 ± 3.678 seconds)(p = 0.004). However, patients in group A (KVVL) had less hemodynamic response compared to group B (MDL) with statistically significant heart rate changes at 3 minutes post intubation. (86.37 ± 15.255 Vs 94.45 ± 19.123 beats/minute respectively)(p = 0.040). There were no significant differences between both the groups in terms of number of attempts and post operative oropharyngeal morbidities. Conclusion:We conclude that King Vision video laryngoscope is a useful alternative to traditional Macintosh laryngoscope for reducing hemodynamic stress response during endotracheal intubation.