Comparison of Haemodynamic Response to Endotracheal Intubation with Videolaryngoscopy and Direct Laryngoscopy in Hypertensive Patients- A Randomised Clinical Trial

Abstract

Introduction: Cardiovascular responses to direct laryngoscopy and endotracheal intubation have been well documented and are caused by noxious stimuli. A videolaryngoscope facilitates visualisation of the vocal cords with minimal stretch on the airways. Aim: To compare the haemodynamic responses to endotracheal intubation with videolaryngoscopy and direct laryngoscopy in hypertensive patients. Materials and Methods: A randomised clinical trial conducted in 90 hypertensive patients. The patients were divided into two groups- Group D in whom conventional (Macintosh) direct laryngoscopy was used and Group V in whom (C-MAC) videolaryngoscopy was used. Haemodynamic parameters were monitored postintubation and to also study the number of intubation attempts, total time taken for intubation, assessment of Cormack-Lehane grade (C-L grade) between C-MAC videolaryngoscopy and direct laryngoscopy. Between the group analyses done using student’s t-test. Multiple paired t-test was used for within group data analysis. Chi-square was used to compare categorical data between the two groups. The p<0.05 will be considered statistically significant. Results: There was no significant difference in haemodynamic response to intubation between both videolaryngoscopy and direct laryngoscopy groups after intubation (p>0.05). Glottic visualisation was significantly better in videolaryngoscopy group using C-L grade (p-value=0.0313). There was no significant difference between the two groups with respect total time taken for laryngoscopy (p-value=0.072). Conclusion: Videolaryngocopy does not have any added advantage over direct laryngoscopy as per Haemodynamic response is considered. Though the visualisation of the glottis is better with videolaryngoscope, duration of laryngoscopy does not differ from routine laryngoscopy