title: Comparison of hemodynamic responses to laryngoscopy and intubation with Truview PCD™, McGrath® and Macintosh laryngoscope in patients undergoing coronary artery bypass grafting: A randomized prospective study.
abstract: BACKGROUND
  We hypothesized that reduced oropharyngolaryngeal stimulation with video laryngoscopes would attenuate hemodynamic response to laryngoscopy and intubation.
  
  
  OBJECTIVE
  Comparison of hemodynamic response to laryngoscopy and intubation with video laryngoscopes and Macintosh (MC) laryngoscope.
  
  
  METHODS
  Superspecialty tertiary care public hospital; prospective, randomized control study.
  
  
  METHODS
  Sixty adult patients undergoing elective coronary artery bypass grafting (CABG) were randomly allocated to three groups of 20 each: MC, McGrath (MG), and Truview™. Hemodynamic parameters were serially recorded before and after intubation. Laryngoscopic grade, laryngoscopy, and tracheal intubation time, ST segment changes, and intra-/post-operative complications were also recorded and compared between groups.
  
  
  METHODS
  SPSS version 17 was used, and appropriate tests applied. P < 0.05 was considered significant.
  
  
  RESULTS
  Heart rate and diastolic arterial pressure increased at 0 and 1 min of intubation in all the three groups (P < 0.05) while mean arterial pressure increased at 0 min in the MG and TV groups and at 1 min in all three groups (P < 0.05). A significant increase in systolic arterial pressure was only observed in TV group at 1 min (P < 0.05). These hemodynamic parameters returned to baseline by 3 min of intubation in all the groups. The intergroup comparisons of all hemodynamic parameters were not significant at any time of observation. Highest intubation difficulty score was observed with MC (2.16 ± 1.86) as compared with MG (0.55 ± 0.88) and TV (0.42 ± 0.83) groups (P = 0.003 and P = 0.001, respectively). However, duration of laryngoscopy and intubation was significantly less in MC (36.68 ± 16.15 s) as compared with MG (75.25 ± 30.94 s) and TV (60.47 ± 27.45 s) groups (P = 0.000 and 0.003, respectively).
  
  
  CONCLUSIONS
  Video laryngoscopes did not demonstrate any advantage in terms of hemodynamic response in patients with normal airway undergoing CABG.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Maulana Azad Medical College and Associated Lok Nayak Hospital, GB Pant and GNEC Hospitals, New Delhi, India.
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Tempe
authors.forename: Kapil
authors.initials: K
authors.lastname: Chaudhary
authors.forename: Anitha
authors.initials: A
authors.lastname: Diwakar
authors.forename: Vishnu
authors.initials: V
authors.lastname: Datt
authors.forename: Sanjula
authors.initials: S
authors.lastname: Virmani
authors.forename: Akhlesh S
authors.initials: AS
authors.lastname: Tomar
authors.forename: Anoop
authors.initials: A
authors.lastname: Mohandas
authors.forename: Vishwanath Bharav
authors.initials: VB
authors.lastname: Mohire
mesh_terms: D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation / Q000379:methods; D062186:Arterial Pressure; D001026:Coronary Artery Bypass / Q000379:methods*; D017558:Elective Surgical Procedures; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation*; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000009:adverse effects* / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies