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. 2014 May;3(2):e17598.
doi: 10.5812/cardiovascmed.17598. Epub 2014 Apr 1.

Hemodynamic changes following endotracheal intubation with glidescope(®) video-laryngoscope in patients with untreated hypertension

Majid Dashti  1 , Shahram Amini  2 , Rasoul Azarfarin  3 , Ziae Totonchi  3 , Maryam Hatami  4
Affiliations

Hemodynamic changes following endotracheal intubation with glidescope(®) video-laryngoscope in patients with untreated hypertension

Majid Dashti et al. Res Cardiovasc Med. 2014 May.

Abstract

Background: Tracheal intubation can be associated with considerable hemodynamic changes, particularly in patients with uncontrolled hypertension. The GlideScope(®) video-laryngoscope (GVL) is a novel video laryngoscope that does not need direct exposure of the vocal cords, and it can also produce lower hemodynamic changes due to lower degrees of trauma and stimuli to the oropharynx than a Macintosh direct laryngoscope (MDL).

Objectives: The aim of this clinical trial was to compare hemodynamic alterations following tracheal intubation with a GVL and MDL in patients with uncontrolled hypertension.

Patients and methods: Sixty patients who had uncontrolled hypertension and scheduled for elective surgery requiring tracheal intubation, were randomly assigned to receive intubated with either a GVL (n = 30) or a MDL (n = 30). Intubation time, heart rate, rate pressure product (RPP), and mean arterial blood pressure (MAP), were compared between the two groups at; baseline, following induction of anesthesia, after intubation, and at one minute intervals for 5 minutes.

Results: A total of 59 patients finished the study. Intubation time was longer in the GVL group (9.80 ± 1.27 s) than in the MDL group (8.20 ± 1.17 s) (P < 0.05). MAP, pulse rate, and RPP were lower in the GVL than the MDL group after endotracheal intubation (P < 0.05). MAP, heart rate, and RPP returned to pre-intubation values at 3 and 4 minutes after intubation in the GVL and MDL groups, respectively (P < 0.05).

Conclusions: Hemodynamic fluctuations in patients with uncontrolled hypertension after endotracheal intubation were lower with the GVL than the MDL technique.

Keywords: Airway Management; Hemodynamics; Hypertension; Intubation, Intratracheal; Laryngoscopes.

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Figures

Figure 1.
Figure 1.. Systolic, Mean and Diastolic arterial Pressure Values During the Study in Both Groups (1 = GVL and 2 = MDL)
GVL, GlideScope® video-laryngoscope; MDL, Macintosh direct laryngoscope.
Figure 2.
Figure 2.. Heart Rate Values During the Study in Both Groups (1 = GVL and 2 = MDL)
GlideScope® video-laryngoscope; MDL, Macintosh direct laryngoscope.
Figure 3.
Figure 3.. RPR values during the study in both groups (1 = GVL and 2 = MDL)
GVL, GlideScope® video-laryngoscope; MDL, Macintosh direct laryngoscope.
See this image and copyright information in PMC

References

    1. Golzari SE, Khan ZH, Ghabili K, Hosseinzadeh H, Soleimanpour H, Azarfarin R, et al. Contributions of Medieval Islamic physicians to the history of tracheostomy. Anesth Analg. 2013;116(5):1123–32. doi: 10.1213/ANE.0b013e3182884313. - DOI - PubMed
    1. Soleimanpour H, Gholipouri C, Panahi JR, Afhami MR, Ghafouri RR, Golzari SE, et al. Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study. BMC Emerg Med. 2011;11:8. doi: 10.1186/1471-227X-11-8. - DOI - PMC - PubMed
    1. Beyer K, Taffe P, Halfon P, Pittet V, Pichard S, Haller G, et al. Hypertension and intra-operative incidents: a multicentre study of 125,000 surgical procedures in Swiss hospitals. Anaesthesia. 2009;64(5):494–502. doi: 10.1111/j.1365-2044.2008.05821.x. - DOI - PubMed
    1. Goldman L, Caldera DL. Risks of general anesthesia and elective operation in the hypertensive patient. Anesthesiology. 1979;50(4):285–92. - PubMed
    1. Helfman SM, Gold MI, DeLisser EA, Herrington CA. Which drug prevents tachycardia and hypertension associated with tracheal intubation: lidocaine, fentanyl, or esmolol? Anesth Analg. 1991;72(4):482–6. - PubMed

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