Haemodynamic response to endotrachial intubation: direct versus video laryngoscopy

Kamewad, Amit Kumar; Sharma, Vipul; Kamewad, Surekha Mudi; Popli, Vitesh

doi:10.18203/2320-6012.ijrms20164040

Cited by 2 publications

(2 citation statements)

References 12 publications

(13 reference statements)

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“…Direct laryngoscopy involves stretching the oropharyngeal tissues in an attempt to straighten the angle between the mouth and the glottic opening, and this stretch can cause pain and trigger stress response. 13 The plasma levels of sympathetic hormones like dopamine, adrenaline and noradrenaline could rise during laryngoscopy and endotracheal intubation. This results in a hemodynamic response that causes complications in high risk patients, leading to increased morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Comparison of acetaminophen and nalbuphine in attenuating hemodynamic response to tracheal intubation.

Faridi¹,

Nasir²,

Haider³

et al. 2020

TPMJ

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Laryngoscopy and tracheal intubation causes sympathetic over activity in the form of increased heart rate and blood pressure, which may lead to deleterious effects. Opioid drugs like fentanyl and nalbuphine are routinely used to attenuate this response during intubation. A few studies have claimed that acetaminophen is efficacious for this purpose too. Various studies have explored its role in blunting of pressor response but none have compared it with nalbuphine. We compared these drugs with the purpose, if both drugs are equally effective; acetaminophen would be a better alternative to nalbuphine without adverse effects of an opioid. Objectives: The objective of this study was to compare the efficacy of acetaminophen and nalbuphine in attenuating hemodynamic response during tracheal intubation. Study Design: Randomized, double-blind clinical trial. Setting: Main operation theatre complex of Fauji Foundation Hospital Rawalpindi. Period: From August to December 2018. Material & Methods: After obtaining permission from institutional ethical review committee of Fauji Foundation Hospital Rawalpindi. 60 Patients of ASA physical status I and II, aged 30 to 55 years, undergoing abdominal surgical procedure of 1 to 3 hour duration were randomly divided into two groups. Patients in group N received nalbuphine hydrochloride 0.15 mg/kg body weight intravenously, 30 minutes before induction. Patients in group P received acetaminophen infusion (paracetamol) 15mg/kg body weight intravenously, 30 minutes before induction. Systolic and diastolic blood pressures were measured manually and heart rate by pulse oximeter. Observations were made before giving analgesics, during induction, 1 minute after intubation, then at every 1- minute intervals till first 5 minutes, and thereafter at 10 minutes and at 15 minutes after intubation. The descriptive statistics of data were expressed as mean and standard deviation. Independent samples t-test was used for comparison of mean values of the variables in both groups. The value of p< 0.05 was considered as statistically significant. Results: There was a significant rise in heart rate and blood pressure after laryngoscopy and endotracheal intubation with acetaminophen (P group) as compared to the N group in which nalbuphine effectively reduced the tachycardia and hypertension. Conclusion: Acetaminophen has no significant effect on the prevention of hemodynamic changes due to intubation. Nalbuphine effectively reduces tachycardia and hypertension associated with laryngoscopy and endotracheal intubation.

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Section: Discussionmentioning

confidence: 99%

Comparison of acetaminophen and nalbuphine in attenuating hemodynamic response to tracheal intubation.

Faridi¹,

Nasir²,

Haider³

et al. 2020

TPMJ

View full text Add to dashboard Cite

show abstract

“…The Lim et al (2005) 10 noticed shortest intubation time in the VL patient group. However, Kamewad et al (2016) 11 studied haemodynamic response to endotracheal intubation: direct versus video laryngoscopy and concluded that duration of laryngoscopy and intubation was significantly longer in video laryngoscopy. Moreover, haemodynamic changes did not show any significant differences between the groups.…”

Section: Discussionmentioning

confidence: 99%

Biochemical markers and haemodynamic changes of stress response after intubation with direct laryngoscopy versus video laryngoscopy versus fiberoptic intubation: A comparative study

Rastogi¹,

Yadav²,

Agarwal³

et al. 2020

IJCA

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Background: Laryngoscopy and intubation leads to stimulation of pharyngeal and tracheolaryngeal nociceptors resulting in haemodynamic stress response (HDSR). Stress response is regulated by two primary neuroendocrine systems-the hypothalamus pituitary adrenocortical (HPA) and sympathetic adrenomedullary (SAM) system. Salivary alpha-amylase (SAA) level can be used as an index of the SAM activity, and serum cortisol as an index of HPA activity. This study was aimed to compare three different intubation techniques namely Macintosh laryngoscope, Video laryngoscope and Fiberoptic bronchoscope to observe stress response. Materials and Methods: This prospective, comparative and observational study was carried out at 120 patients undergoing various elective surgeries under general anaesthesia. Patients were allocated after randomization into three study groups-Group D (Direct laryngoscope), Group V (Video laryngoscope) and Group F (Fiberoptic bronchoscope) with 40 patients in each. Saliva and venous blood samples were collected before inducing the patients and 5-minutes after intubation. Blood pressure, heart rate and saturation were monitored at fixed intervals. Results: A significant difference was observed in the post-intubation values (p=0.0001) of salivary alpha amylase levels by direct laryngoscopy and fiberoptic laryngoscopy, while it was insignificant in video laryngoscopy (p=0.919). Post intubation cortisol level was significantly high in all three groups. However, on group comparison of mean differences of serum cortisol levels, a significant mean difference was seen between D vs V group (p=0.0001), and V vs F group (p=0.0001), while it was not significant in D vs F group (0.157). In addition, changes in mean arterial pressure and heart rate, at 1-and 5-min post-intubation were least in group V. Conclusions: Video laryngoscopy is a safe, and reliable technique. Moreover, it causes lesser stress response to patients in comparison to direct laryngoscopy and fiberoptic groups.

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Haemodynamic response to endotrachial intubation: direct versus video laryngoscopy

Cited by 2 publications

References 12 publications

Comparison of acetaminophen and nalbuphine in attenuating hemodynamic response to tracheal intubation.

Comparison of acetaminophen and nalbuphine in attenuating hemodynamic response to tracheal intubation.

Biochemical markers and haemodynamic changes of stress response after intubation with direct laryngoscopy versus video laryngoscopy versus fiberoptic intubation: A comparative study

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