Anesthesia & Clinical Research
Open Access

Abstract

Comparison of Hemodynamic Response and Complications in Patients with Difficult Airway Using Two Techniques-Retrograde and Fibreoptic Intubation

Abhimanyu Singh, Anil Kumar Paswan, Rajesh Meena, Sekhar Verma, Shashi Prakash, Kavita Meena, Yashpal Singh and R K Verma

Objective: The Aim of this study was to identify the hemodynamic response and success rate to awake retrograde endotracheal intubation (REI) and fiberoptic bronchoscope (FOB) assisted endotracheal intubation in difficult airway situation and to validate whether the REI can attenuate the hemodynamic response to tracheal intubation compared with the FOB assisted intubation.

Design: Randomized Prospective Study.

Methods: 64 adults, ASA I-II scheduled for elective surgery requiring endotracheal intubation were randomly allocated to either the awake REI group (n=32) or the FOB group (n=32). Non-invasive blood pressure (NIBP), heart rate (HR) and Spo2 were recorded. Time taken for intubation and success rate of intubation during the observation was also recorded.

Results: During awake intubation, the magnitude of change of both NIBP and HR was greatest in Group REI as compare to Group FOB. Time taken for intubation and success rate were better in FOB group, while complication like airway trauma was higher in awake retrograde intubation group (REI).

Conclusions: Awake Endotracheal intubation using FOB and REI in adult may cause increases in MAP and HR. However we observed maximum increase in heart rate and MAP occurred at the end of intubation in REI group than FOB, while time taken for intubation were lesser and success rate of intubation were superior in FOB as compare to REI group.