Evaluation of the cardiovascular responses to fiberoptic orotracheal intubation with television monitoring: comparison with conventional direct laryngoscopy

Comparison of hemodynamic responses to endotracheal intubation with the GlideScope video laryngoscope and Macintosh laryngoscope in patients undergoing cardiovascular surgery

“…[20,[25][26][27] These results suggest that the passage of the tracheal tube through the vocal cords and tracheal stimulus is the main cause of the hemodynamic response to endotracheal intubation. [2,22,26,28] A majority of studies have demonstrated that laryngoscopy time was significantly longer in GlideScope however we found no significant difference between the groups in our study. Studies claim that longer intubation time in the GlideScope group may counterbalance the favorable effect of reduced laryngoscope lifting force.…”

“…They did not observe any difference in hemodynamic response between the groups and attributed this to the fact that tracheal stimulation was a major factor for hemodynamic response. [8,14,22,25,30] Similarly, Pournajafian et al [32] also reported that no difference in hemodynamic responses in normotensive patients but they reported increased intubation time with GlideScope. Our results were consistent with these studies; however, laryngoscopy time was similar in both groups in our study.…”

“…As the maximal lifting force applied is suggested to be lower and less neck movement is required during laryngoscopy GlideScope may have advantage over Macintosh for attenuating hemodynamic response to endotracheal intubation. [21,22] Although there are studies that have demonstrated that endotracheal intubation performed by GlideScope and other indirect laryngoscopy devices cause less hemodynamic responses, [11,23,24] recent studies have shown that the hemodynamic responses of both devices are similar. In our study, there was no significant difference between the GlideScope and Macintosh groups in heart rate, systolic, mean and diastolic pressures, as well as RPP during the period of five minutes after endotracheal intubation in consistence with the majority of previous studies.…”

“…[2,29] However, we achieved same results in our study without longer laryngoscopy time that supports the tracheal stimulus theory. [22,26,30] Using GlideScope requires excellent eye-hand coordination because while the performer manipulates the stylet and endotracheal tube, the eyes look to a different location and the performer sees the resulting action only through the monitor. Rotation, withdrawal of the tracheal tube, aligning the tip of the endotracheal tube to the glottis, and positioning the blade can also increase the stimulus since GlideScope has a wider blade than Macintosh and therefore occupies more intraoral space which may require additional maneuvers for the passage of the tracheal tube.…”

A comparative study of overall efficacy and hemodynamic effects following blind oro-tracheal intubation with ILMA vs. conventional direct laryngoscopy guided intubation with Macintosh laryngoscope

“…It is demonstrated in one of the studies that tracheal stimulus is another main cause of haemodynamic responses to tracheal intubation. 14,17 A similar study by Neeraja Bharti and Asit Kumar Naik reported intubation attempts as follows 1 st attempt LS (85%) vs. ILMA (65%), 1 st attempt with adjusting maneuver LS (10%) vs. ILMA (22.5%) and 2 attempts LS (5%) vs. ILMA (10%). Overall success rate of intubation in LS and ILMA group was 100% vs. 97.5%.…”