Effects of Non-Laryngoscopic and Standard Laryngoscopic Intubation Methods on Hemodynamic Responses and Intraocular Pressure

Abstract

Objective: The effects of laryngoscopy on hemodynamic response and intraocular pressure (IOP) are well known. The use of Supra-glottic Airway Devices (SGAD) provides more stable hemodynamic parameters. Aim of this study is to compare the effects of laryngoscopic intubation on hemodynamic responses and IOP with intubation using Cobra Perilaryngeal Airway (Cobra-PLA) and Intubating Laryngeal Mask Airway (ILMA), without laryngoscopy. Methods: Sixty ASA I-II patients, without history of difficult intubation or ophtalmic pathology were randomly allocated into Cobra-PLA (G-PLA), ILMA (G-ILMA), and laryngoscopic intubation (G-L) groups. Induction was achieved with intravenous lidocaine 0.5 mg kg -1 , propofol 1.5-2.5 mg kg -1 and rocuronium 0.6 mg kg -1 . Propofol infusion of 2-4 mg kg -1 h -1 was continued until the 10 th minute following intubation. Intubation was achieved by placing endotracheal tubes through the SGAD into the trachea in G-PLA and G-ILMA, and with a laryngoscope in G-L. Hemodynamic pa-rameters and IOP were recorded before and after induction, the placement of SGAD, before and after intubation, extubation. Results: Demographic characteristics, mouth opening, thyromen-tal distance, and Mallampati score of the groups were similar. Heart rate was significantly higher in G-L than the other groups after intubation (p<0.05). Mean arterial pressure increased with intubation and extubation in all groups, these changes were similar among groups. In comparison between groups, Mean IOP was found to be higher in G-L at the 1st, 2nd and 10th minutes after intubation compared to G-PLA and G-ILMA (p<0.05). Conclusion: It has been found that intubation without laryngoscopy with Cobra-PLA and ILMA cause similar hemodynamic response, especially intubation with Cobra-PLA leads to less IOP rise compared to laryngoscopic intubation.