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Indian Journal of Anesthesia and Analgesia

Volume  7, Issue 3, May-June 2020, Pages 750-756
 

Original Article

Comparison of Hemodynamic Response to Laryngoscopy and Tracheal Intubation in Hypertensive Patients Using Macintosh, McCOY and Truview Video Laryngoscope: A Clinical Study

Madhurima Singh, Vikas Gupta, Aditya Agarwal

1Senior Resident, 2Associate Professor, 3Professor and Head, Dept. of Anesthesiology, Gandhi Medical College, Bhopal, Madhya Pradesh 462001, India

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7320.15

Abstract

Background: Laryngoscopy and intubation produce an exaggerated and unpredictable stress response in hypertensive patients which may lead to the development of life-threatening complications such as pulmonary edema, cerebrovascular hemorrhage and myocardial infarction. It is possible to reduce these harmful and undesirable hemodynamic responses to intubation by using different intubation techniques. The objective of this study was to compare the hemodynamic response to laryngoscopy and endotracheal intubation in hypertensive patients aged 40 years to 60 years using Macintosh, McCoy and Tru View Video laryngoscopes.

Materials and Methods: We studied the hemodynamic response to laryngoscopy and intubation in 90 hypertensive patients posted for elective surgeries requiring general anesthesia, with ASA grading 2 or 3 aged between 40 and 60 years and Mallampati grade 1 and 2 using Macintosh, McCoy and Truview video laryngoscope. The changes in
heart rate, systolic and diastolic blood pressure were observed in the post intubation period, every minute for the  rst 10 minutes.

Results: Patients intubated using Macintosh or McCoy laryngoscope showed signi cantly greater (p < 0.05) rise in heart rate, systolic and diastolic blood pressure during  rst ten minutes in post-intubation period as compared to patients intubated using TruView video laryngoscope. Changes in SpO2 were statistically insigni cant and ECG remained within normal limits. Although time taken to intubate was longer with TruviewVideoaryngoscope.

Conclusions: We conclude that Truview Video laryngoscope provides a better laryngeal view while producing the least hemodynamic response during laryngoscopy and intubation in hypertensive patients as compared to McCoy and Macintosh blades.


Keywords : Hemodynamic response in hypertensive patient, Laryngoscopy and intubation, Macintosh, McCoy, Truview videolaryngoscope.
Corresponding Author : Vikas Kumar Gupta