Comparison of hemodynamic responses to orotracheal intubation with the GlideScope videolaryngoscope and the Macintosh direct laryngoscope.
OBJECTIVE
To identify the hemodynamic responses to orotracheal intubation using a GlideScope videolaryngoscope (GSVL) in healthy adults, and to determine whether the GSVL could attenuate the hemodynamic response to orotracheal intubation compared with the Macintosh direct laryngoscope (MDLS).


METHODS
Randomized study.


METHODS
Operating room, Plastic Surgery Hospital of the Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.


METHODS
57 adult, ASA physical status I patients, scheduled for elective plastic surgery during general anesthesia requiring orotracheal intubation.


METHODS
Patients were randomly allocated to either the GSVL group (n = 30) or the MDLS group (n = 27). Anesthesia was induced with intravenous injection of fentanyl 2 microg/kg, propofol 2 mg/kg, and vecuronium 0.1 mg/kg. Orotracheal intubation was started two minutes after vecuronium injection. All intubation procedures were performed by a single anesthesiologist experienced in using an MDLS and a GSVL. After intubation, anesthesia was maintained with 1% isoflurane and 60% nitrous oxide in oxygen.


RESULTS
Noninvasive blood pressure (BP) and heart rate (HR) were recorded before (baseline values) and immediately after induction (postinduction values), at intubation, and for 5 minutes at one-minute intervals. Maximal BP and HR values during the observation and intubation times were also noted. The product of HR and systolic BP (ie, the rate-pressure product [RPP]) was calculated. Intubation time was significantly longer in the GSVL group than in the MDLS group (P < 0.01). Except for maximal value of diastolic BP in the GSVL group, increases in BPs during the observation in the two groups did not significantly exceed baseline values (P > 0.05). In the GSVL group, HR and RPP at intubation were significantly higher than their baseline values, and HR increases lasted for 4 minutes. In the MDLS group, HR at intubation was also significantly higher than its baseline value, but the tachycardic response lasted only for 1 minute. During the observation, there were no significant differences between the two groups in BPs, HRs, or RPPs at any time points or in their maximal values.


CONCLUSIONS
The hemodynamic responses to orotracheal intubation using a GSVL and an MDLS were similar. The GSVL had no any special advantage over the MDLS in attenuating the hemodynamic responses to orotracheal intubation.
Xue
Fu S
FS
Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100041, People's Republic of China. fruitxue@yahoo.com.cn
Zhang
Guo H
GH
Li
Xuan Y
XY
Sun
Hai T
HT
Li
Ping
P
Li
Cheng W
CW
Liu
Kun P
KP
D000328:Adult; D001794:Blood Pressure; D005260:Female; D006339:Heart Rate; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D020704:Laryngoscopes; D008297:Male; D008875:Middle Aged; D014741:Video Recording / Q000295:instrumentation