Assessment of stress response due to C-Mac D-blade guided videolaryngoscopic endotracheal intubation and docking of da Vinci surgical robot using perfusion index in patients undergoing transoral robotic oncosurgery

Abstract

Clinical utility of perfusion index (PI) has entered a new realm as a non-invasive, quantitative index of stress response to endotracheal intubation. Transoral robotic surgery (TORS) involves F-K retractor aided docking of the surgical robot producing haemodynamic and stress responses akin to laryngoscopy. We compared the stress response to videolaryngoscopy with that due to docking of da Vinci surgical robot using PI, heart rate and mean arterial pressure evaluated at speci c time points post-laryngoscopy and post-docking. MethodsTwenty-six adult patients, scheduled for TORS under general endotracheal anaesthesia were included in this prospective, observational, single-centric cohort study. Statistical analysis included paired samples ttest, dotted box-whisker plots, trendlines and correlograms for comparative analysis of two stressors, laryngoscopy and docking.Results: PI values at baseline, post-midazolam, 1min and 3min post anaesthetic-induction, laryngoscopy, 1min, 3min and 10min post-laryngoscopy, predocking, docking, 1min, 3min and 10min post-docking were