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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 4, July-August 2019, Pages 1227-1234
 

Original Article

Comparative Study of Haemodynamic Response to Intubation with McCoy laryngoscope, Intubating LMA and Vividtrac® Videolaryngoscope in Controlled Hypertensive Patients

Sangeetha C1, Sowmya M Jois2, Yeshaswini Katari3, Venkatesh Murthy KT4

1,2Assistant Professor, 3Junior Resident, 4Professor, Deptt of Anaesthesiology, Raja Rajeswari Medical College and Hospital, Bangalore, Karnataka, 560074, India

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.26

Abstract

Abstract: Laryngoscopy and intubation can result in significant haemodynamic response which is even more exaggerated in hypertensive patients. The magnitude of cardiovascular response is directly related to the force applied and duration of laryngoscopy. Various airway devices and drugs have been tried to limit this pressure response. We conducted a prospective, randomized study to compare the haemodynamic response to intubation using McCoy laryngoscope, Intubating Laryngeal Mask Airway (ILMA) and VividTrac® video laryngoscope in patients with controlled hypertension requiring general anaesthesia for various surgeries. Methods: The study included 90 controlled hypertensive patients of either sex, belonging to ASA grade II, between the age group of 40-60 years, requiring general anaesthesia were divided into three groups. In group M, patients were intubated with a McCoy laryngoscope. In group L, patients were intubated with intubating LMA. In group V, patients were intubated using a VividTrac® video laryngoscope. The haemodynamic response following intubation was compared among all three groups. Intubation time, the success rate of intubation and complications, if any, were also compared in all three groups. Results: It was observed that the VividTrac® video laryngoscope produced significantly less haemodynamic response compared to intubation with ILMA and McCoy laryngoscope. Intubation using McCoy laryngoscope was found to be comparatively a faster method to secure tracheal intubation when compared to ILMA and video laryngoscope. Complications, like oesophageal intubation and sore throat, were more with intubating LMA, whereas injury to oropharyngeal mucosa was found to be observed with VividTrac® video laryngoscope. Conclusion: VividTrac® video laryngoscopy and intubation cause fewer haemodynamic changes compared to Intubating LMA and McCoy laryngoscopy.


Keywords : Keywords: General anaesthesia; Intubation; Haemodynamic response; Controlled hypertension.
Corresponding Author : Sowmya M