Hemodynamic responses to orotracheal intubation with a video laryngoscope in infants: a comparison study

Background: Differences in airway anatomy make the potential for technical airway difficulties greater in infants than in teenagers or adults. Endotracheal intubation by direct vision using a laryngoscope is frequently associated with an increase in arterial blood pressure and heart rate. In different studies, the time to intubation with a video laryngoscope was longer than with direct laryngoscopy using Macintosh, and this longer duration may be accompanied by more hemodynamic responses. METHODS: Sixty-four infants who were scheduled for elective surgery requiring general anesthesia with orotracheal intubation were randomly assigned to intubation by direct laryngoscopy using a Macintosh size 1 blade or to intubation using a video laryngoscope. Systolic and diastolic blood pressures, heart rate and oxygen saturation were recorded at the following time points: (1) before induction, (2) after induction and before intubation, and (3) I minute and (4) 5 minutes after intubation. RESULTS: No significant differences were found either between the two groups or among the different study periods. The duration for laryngoscopy and intubation with a video laryngoscope was 20.87 (PLUS-MINUS) 7.95 seconds (mean (PLUS-MINUS) standard deviation) and that with Macintosh was 15.41 (PLUS-MINUS) 4.1 seconds (P (LESS THAN) 0.01). CONCLUSIONS: Similar hemodynamic responses in both groups suggest that laryngoscopy and intubation with a video laryngoscope, although with longer duration and therefore resulting in more stimulation, has no significant effect on hemodynamic status and oxygen saturation in infants.