title: Hemodynamic changes following endotracheal intubation in patients undergoing cesarean section with general anesthesia: application of glidescope® videolaryngoscope versus direct laryngoscope.
abstract: BACKGROUND
  Endotracheal intubation is usually associated with hemodynamic changes, especially in patients undergoing cesarean section by general anesthesia. GlideScope® videolaryngoscope (GVL) is a novel video laryngoscope, which does not need direct exposure of vocal cords and produces lesser hemodynamic changes due to lower degrees of trauma and stimuli to oropharynx than the Macintosh direct laryngoscope (MDL).
  
  
  OBJECTIVE
  The aim of this study was to compare hemodynamic changes following endotracheal intubation with GVL and MDL in patients undergoing cesarean section by general anesthesia.
  
  
  METHODS
  Seventy patients undergoing elective cesarean section by general anesthesia requiring endotracheal intubation were randomly allocated to be intubated with either GVL (n = 35) or MDL (n = 35). Systolic, diastolic and mean arterial blood pressure (MAP), as well as pulse rates, and rate pressure product (RPP) were compared at baseline, after induction of anesthesia, and after intubation at one-minute interval for five minutes between the two groups. The patients were also compared for Mallampati score, sore throat, intubation time and neonates' Apgar scores.
  
  
  RESULTS
  The patients were similar regarding systolic, diastolic and mean arterial blood pressure. Pulse rate changes were significantly lower only at 1 and 3 minutes in the GVL group. The intubation times were 9.3 ± 1.4 and 10.6 ± 1.7 seconds in the MDL and GVL groups, respectively (P > 0.05). RPP was also lower in the GVL group at 1 and 2 minutes (P < 0.05) and returned to baseline afterwards. There was no significant difference between the groups for Mallampati score, sore throat and Apgar scores.
  
  
  CONCLUSIONS
  Our study revealed that hemodynamic parameters with GVL are only better preserved in the first three minutes after intubation in patients undergoing elective cesarean section and patients are similar regarding intubation time, sore throat and Apgar score.
authors: Department of Anesthesiology and Critical Care, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Shahram
authors: S
authors: Amini
authors: Buali Hospital, Artesh University of Medical Sciences, Birjand, Iran.
authors: Majid
authors: M
authors: Shakib
keywords: Cesarean Section; Endotracheal Intubation; Glidescope; Hemodynamics; Laryngoscope