Research Article

Hemodynamic Stress Response in Controlled Hypertensive Patients: A Randomized Comparison of I-Scope Video Laryngoscope and Macintosh Laryngoscope

Abstract

Background: Laryngoscopy and intubation cause activation of the sympathetic nervous system and can results in tachycardia, arrhythmias and hypertension. Hypertensive patients demonstrate a relatively greater rise in catecholamine secretion and an increased sensitivity to them. Aim of the study is to compare the haemodynamic stress response associated with orotracheal intubation using videolaryngoscope or Macintosh laryngoscope in controlled hypertensive patients.
Methods: Sixty hypertensive, American Society of Anesthesiologist’s class II, patients were randomly divided in to two groups. In group V (videolaryngoscope), intubation was done with i-scope videolaryngoscope. In group M (Macintosh), intubation was done using Macintosh laryngoscope. Primary objectives of the study pulse rate (PR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) were noted immediately after and at 1, 2, 3, 5 and 10 minutes after intubation.
Results: The demographic data were comparable in both groups. There was no significant difference at baseline for mean (SD) PR, SBP, DBP and MBP at baseline and after induction/before intubation (p>0.05). The mean (SD) PR, SBP, DBP and MBP were significantly higher in Macintosh laryngoscope group as compared to i-scope videolaryngoscope immediately after intubation, 1, 2, 3, 5 and 10 minutes after intubation (p<0.001).
Conclusion: We found that intubation with the use of i-scope videolaryngoscope results in less haemodynamic stress response than Macintosh laryngoscope in controlled hypertensive patients.

[1] Ko DD, Kang H, Yang SY, Shin HY, Baek CW, Jung YH, et al. A comparison of hemodynamic changes after endotracheal intubation by the Optiscope™ and the conventional laryngoscope. Korean J Anesthesiol. 2012; 63(2):130-5.
[2] Kanchi M, Nair HC, Banakal S, Murthy K, Murugesan C. Haemodynamic response to endotracheal intubation in coronary artery disease: Direct versus video laryngoscopy. Indian J Anaesth. 2011; 55(3):260-5.
[3] Aggarwal H, Kaur S, Baghla N, Kaur S. Hemodynamic response to orotracheal intubation: comparison between Macintosh, McCoy, and C-MAC video laryngoscope. Anesth Essays Res. 2019; 13(2):308-312.
[4] Padavarahalli Thammanna P, Marasandra Seetharam K, Channasandra Anandaswamy T, Rath P, Chamanhalli Rajappa G, Joseph J. Comparison of Haemodynamic Response to Intubation with KingVision and C-MAC® Videolaryngoscope in Adults. Arch Anesth & Crit Care. 6(2):65-0.
[5] Nalini K, Gopal A, Iyer S, Mungasuvalli N. A Comparative Crossover Randomized Study of Miller and Macintosh Blade for Laryngoscopic View and Ease of Intubating Conditions in Adults. Arch Anesth & Crit Care. 7(2):58-2.
[6] Pournajafian AR, Ghodraty MR, Faiz SH, Rahimzadeh P, Goodarzynejad H, Dogmehchi E. Comparing GlideScope Video Laryngoscope and Macintosh Laryngoscope Regarding Hemodynamic Responses During Orotracheal Intubation: A Randomized Controlled Trial. Iran Red Crescent Med J 2014; 16(4):e12334.
[7] Kihara S, Brimacombe J, Yaguchi Y, Watanabe S, Taguchi N, Komatsuzaki T. Hemodynamic responses among three tracheal intubation devices in normotensive and hypertensive patients. Anesth Analg. 2003; 96(3):890-895.
[8] Jakusenko N, Kopeika U, Mihelsons M, Nagode D, Putina AV, Pavars A. Comparison ofStress Response Performing Endotracheal Intubation By Direct Laryngoscopy, Fibreoptic Intubation And Intubation By The Glidescope Laryngoscope. Proc Latvian Acad Sci. 2008; 62:176-81
[9] Li XY, Xue FS, Sun L, Xu Ya-C, Liu Y, Zhang GH, et al. Comparison of hemodynamic responses to nasotracheal intubations with Glide Scope video-laryngoscope, Macintosh direct laryngoscope, and fiberoptic bronchoscope. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2007; 29(1):117-23
[10] Chemsian RV, Bhananker S, Ramaiah R. Videolaryngoscopy. Int J Crit Illn Inj Sci. 2014; 4(1):35-41
[11] Sperati G, Felisati D. Bouchut, O'Dwyer and laryngeal intubation in patients with croup. Acta Otorhinolaryngol Ital 2007; 27(6):320-3.
[12] Vital Signs: Awareness and Treatment of Uncontrolled Hypertension Among Adults — United States, 2003–2010. Available at URL: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6135a3.htm [last accessed on 27th September, 2020]
[13] New ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension. Available at URL: https://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017 [last accessed 06th Sept 2020]
[14] Mogahed MM, Elghamri MR, Anwar AG. Comparative Study of Intubation Performance between Macintosh, the Channeled KingVision and the C-MAC D-Blade Videolaryngoscope in Controlled Hypertensive Patients. J Anesth Clin Res. 2017; 8:780
[15] Kumar D, Gombar S, Ahuja V, Malhotra A, Gupta S. GlideScope versus D-blade for tracheal intubation in cervical spine patients: A randomised controlled trial. Indian J Anaesth. 2019; 63(7):544-50
[16] Kapoor D, Jindal S, Gombar S, Bajaj N, Atter P, Dalal U. Comparative Evaluation of ProSeal LMA vs. Cuffed Endotracheal Tube in Patients Undergoing Laparoscopic Cholecystectomy under General Anesthesia. Arch Anesth & Crit Care. 4(4):527-34.
[17] Solanki SL, Kaur J. "Two-hand-manoeuver" during nasotracheal intubation. Saudi J Anaesth. 2017; 11:512
[18] Ali QE, Amir SH, Jamil S, Ahmad S. A comparative evaluation of the Airtraq and King Vision video laryngoscope as an intubating aid in adult patients. Acta Anaesthesiol Belg. 2015; 66:81-5
[19] Peirovifar A, Mostafa Gharehbaghi M, Azarfarin R, Karimi L. Comparison of hemodynamic responses to orotracheal intubation in hypertensive patients: laryngoscopy via Macintosh blade versus GlideScope video laryngoscope: 19AP4-2. Euro J Anaesthesiol. 2012; 29:235
[20] Cengiz S, Yılmaz S. The effect of intubation with video and conventional laryngoscopy on hemodynamic response. GKDA Derg. 2019; 25:31-42
[21] Abdelgawad AF, Shi QF, Halawa MA, Wu ZL, Wu ZY, Chen XD, et al. Comparison of cardiac output and hemodynamic responses of intubation among different videolaryngoscopies in normotensive and hypertensive patients. J Huazhong Univ Sci Technol Med Sci. 2015; 35: 432–8.
[22] Hsu WT, Hsu SC, Lee YL, Huang JS, Chen CL. Penetrating injury of the soft palate during GlideScope intubation. Anesth Analg 2007; 104:1609–610
[23] Najafi A, Imani F, Makarem J, Khajavi MR, Etezadi F, Habibi S, et al. Postoperative sore throat after laryngoscopy with macintosh or glide scope video laryngoscope blade in normal airway patients. Anesth Pain Med 2014; 4:e15136.
Files
IssueVol 8 No 1 (2022): Winter QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/aacc.v8i1.8238
Keywords
Haemodynamics Hypertension Laryngoscopes
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Bankar P, kachru N, Yadav R. Hemodynamic Stress Response in Controlled Hypertensive Patients: A Randomized Comparison of I-Scope Video Laryngoscope and Macintosh Laryngoscope. Arch Anesth & Crit Care. 2022;8(1):11-17.