Anesthesia & Clinical Research
Open Access

Abstract

Comparison of Hemodynamic Responses to Orotracheal Intubation by Flexible Fibreoptic Bronchoscope, McCoy Laryngoscope and Airtraq in Presence of Rigid Cervical Collar for Traumatic Cervical Injury

Sidhdharth Sharma, Ritika Aggarwal and Shobha Purohit

Background: Orotracheal Intubation can lead to exaggerated hemodynamic response. In cases of unstable cervical spine placing rigid cervical collar for cervical immobilization to avoid neurological injury may cause hindrance in laryngoscopic view. The aim of our study was to analogize the hemodynamic responses to intubation by flexible Fiberoptic Bronchoscope (FOB), McCoy laryngoscope and airtraq in patients posted for surgery under general anesthesia with rigid collar simulating cervical spine stability in the cases of traumatic cervical injury.

Method: Ninety patients in the age group 20–50 years, of American Society of Anesthesiologist grade I II, posted for surgery under general anesthesia were randomly designated into three groups according to the aid used for intubation: Group A (flexible FOB), Group B (McCoy laryngoscope) and Group C(Airtraq). Systolic blood pressure, diastolic blood pressure, mean arterial blood pressure and Heart Rate (HR) were recorded at baseline, post induction, and shortly one min, three minutes and five minutes post intubation.

Statistical analysis: The categorical data was compared by Chi-square test and P value<0.05 was captured as statistically significant. To compare the quantitative data parametric test (unpaired t test) was done.

Results: The difference in mean arterial pressure with mc coy, airtraq and fiberoptic bronchoscope was significant at one min, three minutes and five minutes after intubation. Similarly there was significant difference in heart rate in intubation with mc coy, airtraq and fiberoptic bronchoscope. The mean duration of intubation was (40 ± 7.28 sec) in fiberoptic group which was statistically significant compared to mc coy (27.3 ± 4.47 sec) and airtraq (25.2 ± 5.11 sec).

Conclusion: Airtraq is better as an aid for orotracheal intubation in traumatic cervical injury with rigid collar as it consumes lesser time and provides stable hemodynamics compared to fiberoptic and mc coy.