Effects of Direct Laryngoscopic and Fiberoptic Intubation on Intraocular Pressure

Study Overview
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Brief Summary
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In this study, the investigators aimed to compare the effects of direct laryngoscopic and fiberoptic endotracheal intubation on intraocular pressure.

Detailed Description
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Material and Method: Total of 54 American Society of Anesthesiologist Grade 1-2, Mallampati score 1 or 2, age between 18 to 65 patient planned to undergo nonopthalmic surgery will be included to study. Patients with glaucoma, diabetes mellitus, cardiovascular and pulmonary diseases, American Society of Anesthesiologist Grade III and IV, body mass index more than 35, difficult intubation, undergo obstetrical surgery and propofol, fentanyl, rocuronium contraindicated will be excluded from the study. Patients will be divided randomly into 2 groups as direct laryngoscopic and fiberoptic intubation group. Patients will be preoxygenated with %100 O2 for 3 minutes then anesthesia will be induced using propofol 2 mg / kg, fentanyl 1 mcg/kg, and rocuronium 0,5 mg / kg in both groups. After 3 minutes mask ventilation, patients will be intubated (women with No:7-7,5, men with No:8-8,5 intubation tube). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, peripheral oxygen saturation,perfusion index will be recorded and intraocular pressure measured by ophthalmologist by tonopen device will be recorded pre-induction (basal), after induction, 1,2,3,5 minutes after intubation, respectively. Period between handling of laryngoscope or fiberoptic device after termination of mask ventilation and obtain end tidal CO2 will be accepted as application time and recorded. Study will be terminated after 5th minute values taken.

Official Title
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Comparison of Effects of Direct Laryngoscopic and Fiberoptic Oral Endotracheal Intubation on Intraocular Pressure

Conditions
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Intraocular Pressure, Intubation Complication

Intervention / Treatment
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* Other: Direct laryngoscope
* Other: Fiberoptic bronchoscope


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA (American Society of Anesthesiologist) Grade 1-2, Mallampati score 1 or 2, Age between 18 to 65 Patient planned to undergo nonopthalmic surgery. Exclusion Criteria: Patients with glaucoma, diabetes mellitus, cardiovascular and pulmonary diseases, ASA Grade III and IV, BMI more than 35, Patients with difficult intubation, Patients undergoing obstetrical surgery and propofol, fentanyl, rocuronium contraindicated.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Fiberoptic bronchoscopy<br>Evaluate the difference between the two groups about hemodynamic and intraocular pressure responses. | Other: Fiberoptic bronchoscope<br>* This device is used in endotracheal intubation and tonopen device for measuring of intraocular pressure. The investigators want to evaluate which one is better.<br>|
| Active Comparator: Direct laryngoscopy<br>Evaluate the difference between the two groups about hemodynamic and intraocular pressure responses. | Other: Direct laryngoscope<br>* This device is used in endotracheal intubation and tonopen device for measuring of intraocular pressure. The investigators want to evaluate which one is better.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Systolic blood pressure |  | From Beginning of Anesthesia induction to 5th minutes of intubation | 
| Heart rate |  | From Beginning of Anesthesia induction to 5th minutes of intubation | 
| Adverse events |  | within the first 24 hour after surgery | 
| Intraocular pressure |  | From Beginning of Anesthesia induction to 5th minutes of intubation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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intraocular pressure, direct laryngoscopy, fiberoptic bronchoscopy