Comparison of Haemodynamic Responses to Video Laryngoscopy versus Flexible Fibreoptic Bronchoscopy for Endotracheal Intubation among Patients Undergoing Elective Surgery under General Anaesthesia: A Randomised Clinical Trial
Introduction: Endotracheal Intubation (ETI) triggers sympathetic stimulation, causing Haemodynamic Stress Responses (HDSRs). Innovations such as video laryngoscopes and flexible fibreoptic bronchoscopes have revolutionised the airway management. Aim: To compare the haemodynamic responses to video l...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&month=July&volume=19&issue=7&page=UC12-UC16&id=21216 |
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| Summary: | Introduction: Endotracheal Intubation (ETI) triggers sympathetic stimulation, causing Haemodynamic Stress Responses (HDSRs). Innovations such as video laryngoscopes and flexible fibreoptic bronchoscopes have revolutionised the airway management.
Aim: To compare the haemodynamic responses to video laryngoscopy versus flexible fibreoptic bronchoscopy for ETI among patients undergoing elective surgery under general anaesthesia.
Materials and Methods: This randomised, single-blinded, clinical study was conducted at the Department of Anaesthesiology, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal, Manipur, India,from September 2022 to July 2024. The present study included sixty patients divided into Group V (video laryngoscope) and Group F (fibreoptic bronchoscope). After a standard intravenous induction, ETI was performed. Haemodynamic parameters were recorded at baseline, at induction, at intubation, and every minute for five minutes. The duration of intubation and postoperative complications were also recorded. Categorical data were presented as frequencies and analysed with the Chi-square test, while quantitative data were presented as mean±standard deviation and compared using an independent t-test. Statistical significance was set at p<0.05.
Results: The present study included 30 participants in each of the two groups, giving a total sample size of 60. The mean age and Body Mass Index (BMI) were 40.16±11.50 years and 22.43±2.36 kg/m² in Group V, and 39.13±10.19 years and 22.84±2.13 kg/m² in Group F. A significant difference in the duration of intubation in seconds (38.40±17.65 for Group V and 50.03±11.81 for Group F, p=0.026) was observed. Baseline haemodynamic parameters were comparable. At induction, Systolic Blood Pressure (SBP: p=0.265), Diastolic Blood Pressure (DBP: p=0.159), Mean Arterial Pressure (MAP: p=0.067), and Heart Rate (HR: p=0.433) were comparable between the groups. SBP differed significantly between the groups at intubation (p=0.046), the 1st minute (p=0.001), and the 2nd minute (p=0.014). Significant differences in DBP were observed at intubation (p=0.001), the 1st minute (p=0.001), the 2nd minute (p=0.002), and the 3rd minute (p=0.007). For MAP, significant differences occurred at intubation (p=0.003), the 1st minute (p=0.0001), the 2nd minute (p=0.001), and the 3rd minute (p=0.005). HR differed significantly at intubation (p=0.042). Sore throat was the only postoperative complication in Group V (p=0.038).
Conclusion: Video laryngoscopy triggered greater HDSRs to intubation compared to flexible fibreoptic bronchoscopy. While video laryngoscopy required less time for intubation, it was associated with a higher incidence of sore throat than the fibreoptic group. |
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| ISSN: | 2249-782X 0973-709X |