Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2019 Feb;35(2):116-122.
doi: 10.1002/kjm2.12017.

Comparison of hemodynamic responses and QTc intervals to tracheal intubation with the McGRATH MAC videolaryngoscope and the Macintosh direct laryngoscope in elderly patients

Fatih Colak  1 , Ulku Ozgul  2 , Mehmet A Erdogan  2 , Gulay E Kayhan  3 , Feray A Erdil  2 , Cemil Çolak  4 , Mahmut Durmus  2
Affiliations
Randomized Controlled Trial

Comparison of hemodynamic responses and QTc intervals to tracheal intubation with the McGRATH MAC videolaryngoscope and the Macintosh direct laryngoscope in elderly patients

Fatih Colak et al. Kaohsiung J Med Sci. 2019 Feb.

Abstract

Our hypothesis was that intubations with the McGRATH MAC videolaryngoscope in elderly patients would produce less hemodynamic responses and ECG changes than the Macintosh direct laryngoscope. The patients were divided into two groups: patients who were intubated using the McGRATH MAC (Group V, n = 45) and patients who were intubated using the Macintosh direct laryngoscope (Group L, n = 45). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR) were recorded before induction with anesthesia (baseline), immediately after induction and at 1 min, 3 min, and 5 min after intubation, with simultaneous ECG. When Group L was compared to Group V, there was an increase in the first, third and fitth minutes after intubation in terms of HR. SBP, MAP increased only at 1 min after intubation and DBP increased in the first and third minutes after intubation in Group L. In Group L, there was a significant difference in the HR values immediately after induction and the first minute after intubation compared with the baseline values. There was a difference in the SBP values immediately after induction and at 3 min and 5 min after intubation compared with the baseline values. There was a difference in DBP and MAP values immediately after induction and at 5 min after intubation. When the McGRATH MAC videolaryngoscope was compared with the Macintosh direct laryngoscope in elderly patients, the McGRATH MAC videolaryngoscope decreased the hemodynamic fluctuations due to tracheal intubation.

Keywords: aged; hemodynamics; intubation; laryngoscopy; videolaryngoscopy.

PubMed Disclaimer

Conflict of interest statement

All authors declare no conflicts of interests.

Figures

Figure 1
Figure 1
CONSORT Diagram for the trial
Figure 2
Figure 2
The changes in heart rate (HR) with Group V and Group L; data are presented as mean ± SD, with n = 45 in each group. t0, baseline; t1, after induction immediately; t2, after intubation 1 min; t3, after intubation 3 min; t4, after intubation 5 min; *P < 0.05 compared with baseline values after significant repeated measures ANOVA; # P < 0.05 between groups based on the unpaired t test. Group V = videolaringoscope group, Group L = direct laryngoscope group
Figure 3
Figure 3
The changes in systolic blood pressure (SBP) with Group V and Group L; data are presented as mean ± SD, with n = 45 in each group. t0, baseline; t1, after induction immediately; t2, after intubation 1 min; t3, after intubation 3 min; t4, after intubation 5 min; *P < 0.05 compared with baseline values after significant repeated measures ANOVA; # P < 0.05 between groups based on the unpaired t test. Group V = videolaringoscope group, Group L = direct laryngoscope group
Figure 4
Figure 4
The changes in mean arterial pressure (MAP) with Group V and Group L; data are presented as mean ± SD, with n = 45 in each group. t0, baseline; t1, after induction immediately; t2, after intubation 1 min; t3, after intubation 3 min; t4, after intubation 5 min; *P < 0.05 compared with baseline values after significant repeated measures ANOVA; # P < 0.05 between groups based on the unpaired t test. Group V = videolaringoscope group, Group L = direct laryngoscope group
Figure 5
Figure 5
The changes in diastolic blood pressure (DBP) with Group V and Group L; data are presented as mean ± SD, with n = 45 in each group. t0, baseline; t1, after induction immediately; t2, after intubation 1 min; t3, after intubation 3 min; t4, after intubation 5 min; *P < 0.05 compared with baseline values after significant repeated measures ANOVA; # P < 0.05 between groups based on the unpaired t test. Group V = videolaringoscope group, Group L = direct laryngoscope group
See this image and copyright information in PMC

References

    1. Yokose M, Mihara T, Kuwahara S, Goto T. Effect of theMcGRATH MAC® Video Laryngoscope on Hemodynamic Responseduring Tracheal Intubation: A Retrospective Study. PLoSOne. 2016;11:e0155566. - PMC - PubMed
    1. 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;35:432–438. - PubMed
    1. Ismail S, Azam SI, Khan FA. Effect of age on haemodynamic response to tracheal intubation. A comparison of young, middle‐aged and elderly patients. Anaesth Intensive Care. 2002;30:608–614. - PubMed
    1. Nakao S, Hatano K, Sumi C, Masuzawa M, Sakamoto S, Ikeda S, et al. Sevoflurane causes greater QTc interval prolongation in elderly patients than in younger patients. Anesth Analg. 2010;110:775–779. - PubMed
    1. Chen YQ, Jin XJ, Liu ZF, Zhu MF. Effects of stellate ganglion block on cardiovascular reaction and heart rate variability in elderly patients during anesthesia induction and endotracheal intubation. J Clin Anesth. 2015;27:140–145. - PubMed

Publication types

LinkOut - more resources