Hemodynamical comparison between Airtraq~((R)) Laryngoscope and Macintosh laryngoscope for orotracheal intubation / 中国组织工程研究

ABSTRACT

BACKGROUND: Orotracheal intubation with conventional Macintosh laryngoscope often makes strong alterations in hemodynamic responses. Compare with the Macintosh laryngoscope, the Airtraq~((R)) laryngoscope has weak effect on throat irritation. However, the contrast effect on hemodynamics remains still unknown. OBJECTIVE: To compare the hemodynamical responses to orotracheal intubation between Airtraq~((R)) laryngoscope and Macintosh laryngoscope. DESIGN, TIME AND SETTING: A randomized comparative observation was performed at Department of Anesthesiology, Dalian Second People's Hospital between October 2008 and April 2009. PARTICIPANTS: A total of 40 patents scheduled for surgery under general anesthesia requiring orotracheal intubation were randomly divided into Airtraq~((R)) laryngoscope group and Macintosh laryngoscope group, with 20 cases in each group. METHODS: After standard intravenous anesthetic induction, orotracheal intubation was performed with Airtraq~((R)) laryngoscope or Macintosh laryngoscope. Common Airtraq~((R)) laryngoscope was used in the Airtraq~((R)) laryngoscope group, and an endotracheal tube with internal diameter of 8.0 was inserted. No. 3 lens were used in the Macintosh laryngoscope group, and an endotracheal tube with internal diameter of 8.0 was inserted. MAIN OUTCOME MEASURES: Glottic exposure time, tracheal intubation time, noninvasive heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) before (T0) and after (T1) anesthetic induction as well as at 0 minute (T2), 1 minute (T3), 2 minutes (T4), and 3 minutes (T5) after intubation, as well as rate-pressure product (RPP). RESULTS: The glottic exposure time in Airtraq~((R)) laryngoscope group was significantly longer than that in Macintosh laryngoscope group (P < 0.01), while the tracheal intubation time in Airtraq~((R)) laryngoscope group was significantly shorter than that in Macintosh laryngoscope group (P < 0.01). Compared with pre-induction (T0), the SBP, DBP, and RPP of the two groups decreased significantly after anesthetic induction (T1) (P < 0.05), but the HR did not change remarkably (P > 0.05). Compared with T1, all hemodynamical values at T2, T3, T4 and T5 in Airtraq~((R)) laryngoscope group did not increased sign ificantly (P > 0.05). In Macintosh laryngoscope group, HR and RPP at T4, SBP, DBP, HR and RPP at T2 and T3 increased significantly compared with T1 (P < 0.05). In Macintosh laryngoscope group, HR and RPP at T2, T3 and T4 were significant higher than that in Airtraq~((R)) laryngoscope group (P< 0.05). CONCLUSION: In comparison to the Macintosh laryngoscope, tracheal intubation with the Airtraq~((R)) laryngoscope resulted in less alterations in hemodynamical responses.