Display options
Cite
Gill N, Purohit S, Kalra P, et al. Comparison of hemodynamic responses to intubation: Flexible fiberoptic bronchoscope versus McCoy laryngoscope in presence of rigid cervical collar simulating cervical immobilization for traumatic cervical spine. Anesth Essays Res. 2015;9(3):337-42doi: 10.4103/0259-1162.158013.
Gill, N., Purohit, S., Kalra, P., Lall, T., & Khare, A. (2015). Comparison of hemodynamic responses to intubation: Flexible fiberoptic bronchoscope versus McCoy laryngoscope in presence of rigid cervical collar simulating cervical immobilization for traumatic cervical spine. Anesthesia, essays and researches, 9(3), 337-42. https://doi.org/10.4103/0259-1162.158013
Gill, Nitesh, et al. "Comparison of hemodynamic responses to intubation: Flexible fiberoptic bronchoscope versus McCoy laryngoscope in presence of rigid cervical collar simulating cervical immobilization for traumatic cervical spine." Anesthesia, essays and researches vol. 9,3 (2015): 337-42. doi: https://doi.org/10.4103/0259-1162.158013
Gill N, Purohit S, Kalra P, Lall T, Khare A. Comparison of hemodynamic responses to intubation: Flexible fiberoptic bronchoscope versus McCoy laryngoscope in presence of rigid cervical collar simulating cervical immobilization for traumatic cervical spine. Anesth Essays Res. 2015 Sep-Dec;9(3):337-42. doi: 10.4103/0259-1162.158013. PMID: 26712970; PMCID: PMC4683510.
Copy Download .nbib Format: NLM
Share it on

Anesth Essays Res. 2015 Sep-Dec;9(3):337-42. doi: 10.4103/0259-1162.158013.

Comparison of hemodynamic responses to intubation: Flexible fiberoptic bronchoscope versus McCoy laryngoscope in presence of rigid cervical collar simulating cervical immobilization for traumatic cervical spine.

Anesthesia, essays and researches

Nitesh Gill, Shobha Purohit, Poonam Kalra, Tarun Lall, Avneesh Khare

Affiliations

  1. Department of Anaesthesiology, S.M.S. Medical College, Jaipur, Rajasthan, India.
  2. Department of Anaesthesiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

PMID: 26712970 PMCID: PMC4683510 DOI: 10.4103/0259-1162.158013

Abstract

BACKGROUND: Intubation is known to cause an exaggerated hemodynamic response in the form of tachycardia, hypertension, and dysrhythmias. In cervical spine instability, intubation has to be performed using cervical immobilization to prevent exacerbation of spinal cord injuries. Application of rigid cervical collar may reduce cervical spine movements, but it hinders tracheal intubation with a standard laryngoscope. The aim of this study was to compare the hemodynamic responses to fiberoptic bronchoscope (FOB) and McCoy laryngoscope in patients undergoing elective surgery under general anesthesia with rigid cervical collar simulating cervical spine immobilization in the situation of cervical trauma.

METHODS: Thirty-two patients in the age range 20-50 years, of American Society of Anaesthesiologist I-II, and of either sex undergoing elective surgery under general anesthesia were randomly allocated into each group. There were two groups according to the technique used for intubation: Group A (flexible FOB) and Group B (McCoy laryngoscope). Systolic blood pressure, diastolic blood pressure, mean arterial blood pressure and heart rate (HR) were recorded at baseline, intraoperatively, immediately before and after induction, and immediately after intubation. Thereafter, every min for next 5 min.

STATISTICAL ANALYSIS: Intergroup comparison of categorical data was done by Chi-square test. P < 0.05 was considered statistically significant. Intergroup comparison of quantitative data was done by the parametric test (unpaired t-test), and probability was considered to be significant if <0.05.

RESULTS: Due to intubation response, HR and blood pressure increased significantly (P < 0.05) above preoperative values in McCoy group as compared to the fiberoptic group.

CONCLUSION: We suggest that the flexible FOB is an effective and better method of intubation in a situation like traumatic cervical spine injury and provides stable hemodynamics.

Keywords: Fiberoptic bronchoscope; McCoy laryngoscope; hemodynamic response; intubation

References

  1. Indian J Anaesth. 2012 Nov;56(6):529-34 - PubMed
  2. Anaesthesia. 1996 Nov;51(11):1026-8 - PubMed
  3. Indian J Anaesth. 2012 Jul;56(4):353-8 - PubMed
  4. Anesthesiology. 1989 Sep;71(3):470-1 - PubMed
  5. J Anaesthesiol Clin Pharmacol. 2013 Apr;29(2):196-9 - PubMed
  6. Masui. 1997 Nov;46(11):1519-24 - PubMed
  7. Br J Anaesth. 1997 Dec;79(6):714-8 - PubMed
  8. J Postgrad Med. 2005 Oct-Dec;51(4):260-4; discussion 264-5 - PubMed
  9. Br J Anaesth. 1992 May;68(5):529-30 - PubMed
  10. Anaesthesia. 2002 Sep;57(9):909-13 - PubMed
  11. Anaesthesia. 1993 Jun;48(6):516-9 - PubMed
  12. J Anesth. 1992 Jul;6(3):262-8 - PubMed
  13. Anaesthesia. 1997 Feb;52(2):131-5 - PubMed
  14. Br J Anaesth. 2005 Sep;95(3):344-8 - PubMed
  15. Br J Anaesth. 2000 Feb;84(2):254-6 - PubMed
  16. Can J Anaesth. 1997 Jun;44(6):674-6 - PubMed
  17. Masui. 1998 Aug;47(8):998-1001 - PubMed
  18. Anaesthesia. 1996 Jan;51(1):74-5 - PubMed
  19. Int J Technol Assess Health Care. 2007 Spring;23(2):255-60 - PubMed
  20. Br J Anaesth. 1987 Mar;59(3):295-9 - PubMed
  21. Anaesthesia. 1995 Nov;50(11):943-6 - PubMed
  22. Anesthesiology. 1992 Jan;76(1):151-2 - PubMed
  23. Anesth Analg. 2002 Jul;95(1):233-7, table of contents - PubMed
  24. Anaesthesia. 1996 Sep;51(9):812-4 - PubMed
  25. J Clin Anesth. 2003 Mar;15(2):132-6 - PubMed
  26. Anesthesiology. 1993 Mar;78(3):580-3 - PubMed
  27. Acta Anaesthesiol Scand. 1994 Jul;38(5):510-3 - PubMed
  28. Anaesthesia. 1992 Jan;47(1):20-3 - PubMed
  29. J Clin Anesth. 2000 Nov;12(7):503-8 - PubMed
  30. Clin Chest Med. 2001 Jun;22(2):281-99 - PubMed
  31. Saudi J Anaesth. 2012 Jul;6(3):248-53 - PubMed
  32. Rev Esp Anestesiol Reanim. 1996 May;43(5):177-9 - PubMed
  33. Eur J Anaesthesiol. 2001 Feb;18(2):108-12 - PubMed

Publication Types