Comparison of Hemodynamic Changes by Using the Videolaryngoscope and the Macintosh Laryngoscope

Study Overview
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Brief Summary
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Tracheal intubation techniques that avoid or minimize pharyngolaryngeal stimulation might attenuate the hemodynamic stress response. Tracheal intubation using video laryngoscope needs comparatively less airway manipulation so, the investigators expect less hemodynamic response while using videolaryngoscope.

Detailed Description
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The hemodynamic stress response to tracheal intubation can precipitate adverse cardiovascular events in patients with cardiovascular disease. Which is shown to greatly increase the risk of myocardial infarction or stroke, especially in elderly patients with hypertension. Direct laryngoscopy and laryngoscopic stimulation of pharyngolaryngeal structures may be an important factor in the hemodynamic stress response associated with tracheal intubation. Patients were randomly allocated to two groups using a permuted block randomization method: 1) patients intubated by using the videolaryngoscopy 2) patients intubated by using the Macintosh laryngoscope . SAP, MAP, and heart rate were measured and recorded in the operating room: At baseline, before intubation, immediately after intubation and 1,2,3,4 and 5 minutes after tracheal intubation.

Official Title
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Comparison of Hemodynamic Changes After Endotracheal Intubation by Using the Videolaryngoscope and the Macintosh Direct Laryngoscope in Elderly Hypertensive Patients

Conditions
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Anesthesia Intubation Complication

Intervention / Treatment
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* Device: videolaryngoscope
* Device: Macintosh laryngoscope


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologists Physical Status II-III, aged over 65 years, controlled hypertensive patients, scheduled for elective coronary artery bypass grafting. Exclusion Criteria: American Society of Anesthesiologists Physical Status IV, ejection fraction < 40%, any anatomical abnormality in head, neck or face, Mallampati score of IV, history of difficult intubation or laryngoscopy

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 90 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: videolaryngoscope<br>patients intubated by using the videolaryngoscopy | Device: videolaryngoscope<br>* patients intubated by using the videolaryngoscope<br>|
| Active Comparator: Macintosh laryngoscope<br>patients intubated by using the Macintosh laryngoscope | Device: Macintosh laryngoscope<br>* patients intubated by using the Macintosh laryngoscope<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood pressure changes during tracheal intubation ( mmHg ) , |  | At baseline, 1 minute before intubation, and 1,2,3,4 and 5 minutes after tracheal intubation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart rate changes during tracheal intubation (beats per minute) |  | At baseline, 1 minute before intubation, and 1,2,3,4 and 5 minutes after tracheal intubation | 
| ST segment elevation in electrocardiogram indicating myocardial ischaemia during tracheal intubation | During tracheal intubation electrocardiogram is monitorized. | At baseline, 1 and 5 minutes after tracheal intubation. | 
| Arrhythmic changes in electrocardiogram during tracheal intubation | During tracheal intubation electrocardiogram is monitorized. | At baseline, 1 and 5 minutes after tracheal intubation. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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videolaryngoscope, direct laryngoscope, hemodynamic changes, elderly patients