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A Comparative Study of Hemodynamic Response and Ease of Intubation in Patients Intubated by Direct Laryngoscopy Versus Lightwand

Kirti A. Kundalwal, Assistant Professor, Department of Anaesthesia, B.J. Govt. Medical College, Pune, Maharashtra 411001, India. , Prajakta M. Tayade1 , Kirti A. Kundalwal2 , Rohit P. Sancheti3

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Indian Journal of Anesthesia and Analgesia 5(11):p 1880-1887, November-December 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.16

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Abstract

  Introduction: Direct laryngoscopic endotracheal intubation is associated with varying degrees of sympathetic activity which may be detrimental in patients with coexisting conditions, such as coronary artery disease, elevated intracranial pressure and asthma. Lightwand intubation, on the other hand, by avoiding direct laryngoscopy, is expected to cause lesser hemodynamic variations. Aim: This randomised and prospective study intends to compare the hemodynamic response to intubation and ease of intubation by both these procedures. Settings and design: Prospective randomised single blind study. Material Methods: Hundred normotensive patients of either sex, age 18 to 60 years, ASA I & II, with normal airway scheduled to undergo elective surgeries under general anaesthesia were included in the study. They were randomly divided into two groups­DL (direct laryngoscopic intubation) & LW (lightwand intubation). Preoperatively heart rate, systolic, diastolic and mean blood pressure were recorded. Above parameters were also noted at 0, 1, 3, 5 minutes after intubation in both the groups. The time taken and the number of attempts required for successful intubation were noted. Results were statistically analysed. Statistical analysis used: Paired and unpaired student’s t­test. Results: Hemodynamic response was more in DL group than in LW group which was statistically significant. Whereas, time taken for intubation was statistically significantly more with lightwand (20.08±7.07 secs) as compared to direct laryngoscopic intubation (16.94±4.55 secs). Conclusion: Lightwand intubation was associated with lesser hemodynamic response however the time taken for intubation by lightwand was more as compared to direct laryngoscopic intubation. 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.16

Keywords

Lightwand; Direct Laryngoscopy; Endotracheal Intubation; Time Taken for Intubation.

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