title: Influence of GlideScope assisted endotracheal intubation on intraocular pressure in ophthalmic patients.
abstract: BACKGROUND
  Traditional Macintoch laryngoscopy is known to cause a rise in intraocular pressure (IOP), tachycardia and hypertension. These changes are not desirable in patients with glaucoma and open globe injury. GlideScope is a video laryngoscope that functions independent of the line of sight, reduces upward lifting forces for glottic exposure and requires less cervical neck movement for intubation, making it less stimulating than Macintosh laryngoscopy.
  
  
  OBJECTIVE
  The aim was to assess the variations in IOP and hemodynamic changes after GlideScope assisted intubation.
  
  
  METHODS
  After approval of the local Institutional Research and Ethical Board and informed patient consent, 50 adult American Society of Anesthesiologist I and II patients with normal IOP were enrolled in a prospective, randomized study for ophthalmic surgery requiring tracheal intubation. In all patients, trachea was intubated using either GlideScope or Macintoch laryngoscope. IOP of nonoperated eye, heart rate and blood pressure were measured as baseline, 1 min after induction, 1 min and 5 min after tracheal intubation.
  
  
  RESULTS
  IOP was not significantly different between groups before and after anesthetic induction and 5 min after tracheal intubation (P = 0.217, 0.726, and 0.110 respectively). The only significant difference in IOP was at 1 min after intubation (P = 0.041). No significant difference noted between groups in mean arterial pressure (P = 0.899, 0.62, 0.47, 0.82 respectively) and heart rate (P = 0.21, 0.72, 0.07, 0.29, respectively) at all measurements.
  
  
  CONCLUSIONS
  GlideScope assisted tracheal intubation shown lesser rise in IOP at 1 min after intubation in comparison to Macintoch laryngoscope, suggesting that GlideScope may be preferable to Macintosh laryngoscope.
authors.affiliation: Department of Anesthesia, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Nauman
authors.initials: N
authors.lastname: Ahmad
authors.affiliation: Department of Anesthesia, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Abdul
authors.initials: A
authors.lastname: Zahoor
authors.affiliation: Department of Anesthesia, St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Waleed
authors.initials: W
authors.lastname: Riad
authors.affiliation: Department of Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Saeed
authors.initials: S
authors.lastname: Al Motowa
keywords: GlideScope; hemodynamic response; intraocular pressure; intubation
references.citation: Anesth Analg. 2002 Aug;95(2):480-4, table of contents
references.pmid: 12145076
references.citation: Anesth Analg. 2003 Mar;96(3):890-5, table of contents
references.pmid: 12598280
references.citation: Br J Anaesth. 2005 Mar;94(3):381-4
references.pmid: 15567809
references.citation: Br J Anaesth. 1988 Mar;60(4):379-83
references.pmid: 2895663
references.citation: Middle East J Anaesthesiol. 2011 Oct;21(3):385-90
references.pmid: 22428493
references.citation: Anesth Analg. 2005 Sep;101(3):910-5, table of contents
references.pmid: 16116013
references.citation: BMC Anesthesiol. 2012 Jun 21;12:11
references.pmid: 22720884
references.citation: Anaesth Intensive Care. 2008 May;36(3):431-5
references.pmid: 18564806
references.citation: Emerg Med J. 2008 May;25(5):279-82
references.pmid: 18434462
references.citation: Anesth Analg. 1992 Sep;75(3):355-60
references.pmid: 1510256
references.citation: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2007 Feb;29(1):117-23
references.pmid: 17380681
references.citation: Iran Red Crescent Med J. 2014 Apr;16(4):e12334
references.pmid: 24910788