Azarina, Zakaria
(2008)
A comparative study between glidescope®
videolaryngoscope and direct laryngoscope
using modified rapid sequence induction on
haemodynamic parameters during intubation.
Masters thesis, Pusat Pengajian Sains Perubatan.
Abstract
There are different techniques of intubation of trachea apart from standard direct
laryngoscopy. Every technique produces sympathetic response in varying
degrees. Glidescope® videolaryngoscope, is a relatively new intubating device
to improve the glottic view without aligning the three airway axes as done in
standard direct laryngoscopy and is said to cause less airway manipulations.
Our study is to see if Glidescope® videolaryngoscopic technique would alter the
sympathetic response as normally seen in standard laryngoscopy. To assess haemodynamic responses between direct laryngoscopy and
Glidescope® videolaryngoscope during laryngoscopy and intubation. This is a prospective randomized study involving 64 ASA I and II patients divided
into 2 groups (n=32); direct laryngoscopy and Glidescope® group. Anaesthesia
was induced with intravenous injection of fentanyl 1.51Jg/kg, propofol 2mg/kg and
rocuronium 1 mg/kg. Orotracheal intubation was started at least 1 minute after
rocuronium injection. Noninvasive blood pressure (BP), heart rate and oxygen
saturation were recorded before (baseline value) and immediately after induction,
during intubation, and for 5 minutes later, at one-minute intervals. Intubation time was significantly longer in the Glidescope® group (mean
35.67±9.59sec) when compared to direct laryngoscopy group (mean
20.13±5.03sec), p<0.001. In the Glidescope® group, the systolic blood pressure,
diastolic blood pressure, mean arterial pressure and heart rate were significantly
higher than the direct laryngoscopy group. The increase in heart rate in
Glidescope® group took more than 5 minutes to return to baseline values
compared to only 3 minutes in direct laryngoscopy group. Direct laryngoscopy showed better haemodynamic parameters of mean SBP,
DBP, MAP and heart rate compared to Glidescope® videolaryngoscope.
However, the increase in haemodynamic parameters in the Glidescope® group
was not more than 20% of baseline values and this was still acceptable to our
routine standard anaesthetic management.
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