Hemodynamic responses to orotracheal intubation with a video laryngoscope
Abstract
Background: Differences in airway anatomy make the potential for technical airway difficulties greater in infants than in
teenagers or adults. Endotracheal intubation by direct vision using a laryngoscope is frequently associated with an increase
in arterial blood pressure and heart rate. In different studies, the time to intubation with a video laryngoscope was
longer than with direct laryngoscopy using Macintosh, and this longer duration may be accompanied by more hemodynamic
responses.
METHODS: Sixty-four infants who were scheduled for elective surgery requiring general anesthesia with orotracheal
intubation were randomly assigned to intubation by direct laryngoscopy using a Macintosh size 1 blade or to intubation
using a video laryngoscope. Systolic and diastolic blood pressures, heart rate and oxygen saturation were recorded at the
following time points: (1) before induction, (2) after induction and before intubation, and (3) 1 minute and (4) 5 minutes
after intubation.
RESULTS: No significant differences were found either between the two groups or among the different study periods.
The duration for laryngoscopy and intubation with a video laryngoscope was 20.87 ± 7.95 seconds (mean ± standard
deviation) and that with Macintosh was 15.41 ± 4.1 seconds (P < 0.01).
CONCLUSIONS: Similar hemodynamic responses in both groups suggest that laryngoscopy and intubation with a video
laryngoscope, although with longer duration and therefore resulting in more stimulation, has no significant effect on
hemodynamic status and oxygen saturation in infants.
KEY WORDS: Video laryngoscope, laryngoscopy, blood pressure, heart rate
teenagers or adults. Endotracheal intubation by direct vision using a laryngoscope is frequently associated with an increase
in arterial blood pressure and heart rate. In different studies, the time to intubation with a video laryngoscope was
longer than with direct laryngoscopy using Macintosh, and this longer duration may be accompanied by more hemodynamic
responses.
METHODS: Sixty-four infants who were scheduled for elective surgery requiring general anesthesia with orotracheal
intubation were randomly assigned to intubation by direct laryngoscopy using a Macintosh size 1 blade or to intubation
using a video laryngoscope. Systolic and diastolic blood pressures, heart rate and oxygen saturation were recorded at the
following time points: (1) before induction, (2) after induction and before intubation, and (3) 1 minute and (4) 5 minutes
after intubation.
RESULTS: No significant differences were found either between the two groups or among the different study periods.
The duration for laryngoscopy and intubation with a video laryngoscope was 20.87 ± 7.95 seconds (mean ± standard
deviation) and that with Macintosh was 15.41 ± 4.1 seconds (P < 0.01).
CONCLUSIONS: Similar hemodynamic responses in both groups suggest that laryngoscopy and intubation with a video
laryngoscope, although with longer duration and therefore resulting in more stimulation, has no significant effect on
hemodynamic status and oxygen saturation in infants.
KEY WORDS: Video laryngoscope, laryngoscopy, blood pressure, heart rate
Keywords
Video laryngoscope, laryngoscopy, blood pressure, heart rate