Hemodynamic changes during orotracheal intubation using Airtraq video laryngoscope and direct laryngoscope: A randomized comparative study

Abstract

Introduction: Direct laryngoscopy is associated with sympathetic stimulation and altered hemodynamics. A long intubation time may result in a greater in stress response. Alternative techniques using video laryngoscopes have been developed that do not require direct vocal cord visualization and may decrease the hemodynamic response. This study aimed to compare the difference between hemodynamic changes and intubation time with Airtraq video laryngoscope and conventionl Macintosh direct laryngoscope.
 Methods: A prospective randomized comparative study was conducted involving 100 adult patients who were undergoing elective surgeries under general anesthesia and endotracheal intubation. The patients were randomly assigned to group V (Video laryngoscope) or group D (Direct laryngoscope). In addition to the baseline vitals and vitals at various time intervals, intubation time was also recorded. We considered a difference in Heart Rate and Mean Arterial pressure of 20% to be clinically significant and statistical significance was p-value <0.05.
 Results: Significant difference was found in heart rates immediately after laryngoscopy (110.40 vs. 105.02 beats/minute; p<0.01) and 1 minute after intubation (109.30 vs. 106.20 beats/minute; p<0.01) with attenuation seen in video laryngoscopy group. Blood pressures were similar in both the groups at all times. Time for intubation was prolonged in video laryngoscopy group than that for direct laryngoscopy group (26.54 vs. 22.80 seconds; p<0.05). There were no adverse events associated with either of the techniques. 
 Conclusions: The Airtraq video laryngoscopy resulted in lesser change in heart rate and longer intubation time. However, clinical impact of such a difference seemed to be insignificant.

A prospective observational study on predicting the risk of obstructive sleep apnea and difficult intubation in patients posted for elective surgery

“…Both groups were comparable and none of the p value was significant. Upadhyaya S [9] conducted a randomized comparative study on Hemodynamic changes during orotracheal intubation using Airtraq video laryngoscope and direct laryngoscope and found that Blood pressures were similar in both the groups at all times of intubation similar to our study. As per our study there is no difference in haemodynamic parameters in both the groups.…”

Effect of Remifentanil Bolus vs Fentanyl in Attenuating Hemodynamic Response in Videolaryngoscopic Endotracheal Intubation

“…ET intubation is aided by a metal stylet (11) . Since introduction of modern anesthesia technique, many studies have been conducted on hemodynamic changes following endotracheal intubation comparing videolaryngoscope to conventional type with different results (12,13) .…”