Hemodynamic stress response to reinforced endotracheal tube placement using Upsher scope and Macintosh laryngoscope: A comparative study
Abstract
Objective: Endotracheal intubation leads to hemodynamic stress response that can be deleterious. The purpose of this study was to compare the intubation response to reinforced (R) endotracheal tube (ETT) placement using Upsher scope and Mcintosh laryngoscope.
Methodology: Eighty ASA I patients scheduled to undergo surgery under GA, requiring use of R ETT were enrolled. Time to successful intubation, need for external neck manipulation; and end tidal concentration of sevoflurane and carbon dioxide at the time of intubation were recorded. Heart rate, systolic and diastolic BP were recorded as baseline, after induction of anesthesia and at one minute interval for five minutes after intubation.
Results: Time to intubation was significantly longer in Upsher scope group (64 v.s 23 seconds) compared to Mcintosh group (P < 0.05). There was significantly more rise in heart rate, systolic and diastolic BP after intubation in Upsher scope group compared with Mcintosh group (P < 0.05) and the rise persisted for 4, 3 and 4 minutes in respective parameters. Significantly more number of patients in Upsher scope group required external neck manipulation in an attempt to align the tip of the ETT and the glottis.
Conclusion: Time required for successful ET intubation of R ETT using Upsher scope and the need for external neck manipulation was more compared with Mcintosh laryngoscope; and it resulted in significant increase in BP and HR in patients with normal airway and without any comorbidity.
Methodology: Eighty ASA I patients scheduled to undergo surgery under GA, requiring use of R ETT were enrolled. Time to successful intubation, need for external neck manipulation; and end tidal concentration of sevoflurane and carbon dioxide at the time of intubation were recorded. Heart rate, systolic and diastolic BP were recorded as baseline, after induction of anesthesia and at one minute interval for five minutes after intubation.
Results: Time to intubation was significantly longer in Upsher scope group (64 v.s 23 seconds) compared to Mcintosh group (P < 0.05). There was significantly more rise in heart rate, systolic and diastolic BP after intubation in Upsher scope group compared with Mcintosh group (P < 0.05) and the rise persisted for 4, 3 and 4 minutes in respective parameters. Significantly more number of patients in Upsher scope group required external neck manipulation in an attempt to align the tip of the ETT and the glottis.
Conclusion: Time required for successful ET intubation of R ETT using Upsher scope and the need for external neck manipulation was more compared with Mcintosh laryngoscope; and it resulted in significant increase in BP and HR in patients with normal airway and without any comorbidity.
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