title: Hemodynamic changes following endotracheal intubation with glidescope(®) video-laryngoscope in patients with untreated hypertension.
abstract: BACKGROUND
  Tracheal intubation can be associated with considerable hemodynamic changes, particularly in patients with uncontrolled hypertension. The GlideScope(®) video-laryngoscope (GVL) is a novel video laryngoscope that does not need direct exposure of the vocal cords, and it can also produce lower hemodynamic changes due to lower degrees of trauma and stimuli to the oropharynx than a Macintosh direct laryngoscope (MDL).
  
  
  OBJECTIVE
  The aim of this clinical trial was to compare hemodynamic alterations following tracheal intubation with a GVL and MDL in patients with uncontrolled hypertension.
  
  
  METHODS
  Sixty patients who had uncontrolled hypertension and scheduled for elective surgery requiring tracheal intubation, were randomly assigned to receive intubated with either a GVL (n = 30) or a MDL (n = 30). Intubation time, heart rate, rate pressure product (RPP), and mean arterial blood pressure (MAP), were compared between the two groups at; baseline, following induction of anesthesia, after intubation, and at one minute intervals for 5 minutes.
  
  
  RESULTS
  A total of 59 patients finished the study. Intubation time was longer in the GVL group (9.80 ± 1.27 s) than in the MDL group (8.20 ± 1.17 s) (P < 0.05). MAP, pulse rate, and RPP were lower in the GVL than the MDL group after endotracheal intubation (P < 0.05). MAP, heart rate, and RPP returned to pre-intubation values at 3 and 4 minutes after intubation in the GVL and MDL groups, respectively (P < 0.05).
  
  
  CONCLUSIONS
  Hemodynamic fluctuations in patients with uncontrolled hypertension after endotracheal intubation were lower with the GVL than the MDL technique.
authors.affiliation: Anesthesiology Department, Sadoughi University of Medical Sciences, Yazd, IR Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Dashti
authors.affiliation: Anesthesiology Department, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Amini
authors.affiliation: Rajaie Cardiovascular and Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Rasoul
authors.initials: R
authors.lastname: Azarfarin
authors.affiliation: Rajaie Cardiovascular and Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Ziae
authors.initials: Z
authors.lastname: Totonchi
authors.affiliation: Pain Clinic, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Hatami
keywords: Airway Management; Hemodynamics; Hypertension; Intubation, Intratracheal; Laryngoscopes