Anesth Pain Med.  2017 Oct;12(4):342-347. 10.17085/apm.2017.12.4.342.

Hemodynamic response to tracheal intubation and postoperative pharyngeal morbidity using GlideScope®, Lightwand and Macintosh laryngoscopes during remifentanil infusion

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. khlee6006@yonsei.ac.kr

Abstract

BACKGROUND
Use of GlideScope® laryngoscopes and lightwands for tracheal intubation does not require much force. Theoretically, less stimulation can reduce hemodynamic changes during intubation. We investigated the hemodynamic response to tracheal intubation using different laryngoscope types during remifentanil infusion.
METHODS
Sixty American Society of Anesthesiologists class I-II patients were compared in terms of tracheal intubation time, hemodynamic changes, and postoperative pharyngeal complications when using a GlideScope®, lightwand, or Macintosh laryngoscope. Propofol and rocuronium were injected and remifentanil was infused for three minutes. Blood pressure and heart rate were measured before and 1, 3, and 5 minutes after tracheal intubation. Patients were assessed for postoperative oral and tracheal bleeding as well as hoarseness, dysphagia, and sore throat.
RESULTS
Intubation time was prolonged in the GlideScope® group. All three groups showed a significant decrease in systolic and diastolic blood pressure 1, 3, and 5 minutesafter tracheal intubation. Heart rates increased significantly in all three groups immediately after intubation as well as 1 minute later in the GlideScope® group. However, there were no differences in blood pressure, heart rate, or the occurrence of hoarseness, dysphagia, and sore throat among the three groups.
CONCLUSIONS
No differences in hemodynamic change were found among the three different techniques.

Keyword

Hemodynamic change; Intubation; Laryngoscope; Remifentanil

MeSH Terms

Blood Pressure
Deglutition Disorders
Heart Rate
Hemodynamics*
Hemorrhage
Hoarseness
Humans
Intubation*
Laryngoscopes*
Pharyngitis
Propofol
Propofol

Figure

  • Fig. 1 Comparison of systolic blood pressure (SBP) changes. All values are expressed as mean ± SD. BL = baseline, BI = before intubation, AI = immediately after intubation. T1–T5 = points of time as minutes after intubation. †Compared with baseline values in GlideScope® group. *Compared with baseline values in Lightwand group. ‡Compared with baseline values in Macintosh group. *,†,‡P < 0.05 compared with baseline values.

  • Fig. 2 Comparison of diastolic blood pressure (DBP) changes. All values are expressed as mean ± SD. BL = baseline, BI = before intubation, AI = immediately after intubation. T1–T5 = points of time as minutes after intubation. †Compared with baseline values in GlideScope® group. *Compared with baseline values in Lightwand group. ‡Compared with baseline values in Macintosh group. *,†,‡P < 0.05 compared with baseline values.

  • Fig. 3 Comparison of heart rate (HR) changes. All values are expressed as mean ± SD. BL = baseline, BI = before intubation, AI = immediately after intubation. T1–T5 = points of time as minutes after intubation. †Compared with baseline values in GlideScope® group. *Compared with baseline values in Lightwand group. ‡Compared with baseline values in Macintosh group. *,†,‡P < 0.05 compared with baseline values.


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