Comparison of the hemodynamic changes of orotracheal intubation in patients with a history of hypertension by direct laryngoscopy with the Macintosh blade of the video laryngoscope

Abstract

Since the length of laryngoscopy and its accuracy are very important in the matter of intubation, and the first effects of laryngoscopy show on the hemodynamic status, and since patients with a history of hypertension are associated with increased pressure during laryngoscopy, and this requires Finding the laryngoscopy method is safe and considering that the safety of different laryngoscopy methods in these patients has not been confirmed in past studies, the present study was designed to achieve this problem; Therefore, the purpose of this study is to investigate the difference in the effect of laryngoscopy with Mcintosh blade compared to video laryngoscopy (i.e. Glidescope) on the hemodynamics of patients, especially with emphasis on patients with a history of hypertension. Methods: In this study, which is a randomized, double-blind clinical trial study with a prospective approach, 30 patients were randomly assigned to the video laryngoscope group (i.e. Glidescope) and 30 patients to the normal laryngoscopy with Macintosh. Baseline BP and HR values will be recorded after a 5-minute stabilization period. BP and HR were recorded immediately after induction (post-induction values), at intubation, and every minute for the first 5 minutes after intubation. Mean arterial blood pressure or MAP = (SBP + 2DBP)/3 (sum of twice the diastolic pressure and systolic pressure divided by 3) was calculated. Intubation time, that is, the period from the end of manual ventilation using a face mask to the resumption of ventilation through the tracheal tube, was recorded using a stopwatch. Patients who required more than one attempt to achieve successful intubation were excluded from statistical data analysis. Results: It was observed that in the McIntosh group, after intubation, the increase in heart rate in the first minute was significantly higher than in the videolaryngoscope group (P=0.025), in other measured times, the heart rate in the McIntosh group was insignificant. It was more than the videolaryngoscope group; Diastolic, systolic and mean arterial blood pressures in the Mackintosh group after intubation were significantly higher than the videolaryngoscope group at all times (P˂0.05).