A prospective randomized comparative study of Glidescope versus Macintosh laryngoscope in adult hypertensive patients

Abstract

Background: Endotracheal intubation with the Macintosh has been associated with difficult visualization of the glottis, difficult intubation, high force,extensive manipulation with significant hemodynamic changes, which may be life threatening in vulnerable patients. We assume that Glidescope has less hemodynamic effects and less postoperative complication. Methods: Ninety eligible patients with controlled hypertension were randomly allocated into two groups with 45 patient in each group, G group for the Glidescope and M group for the Macintosh. Both groups were compared for hemodynamic changes including systolic, diastolic, mean blood pressure, heart rate as primary outcome while first attempt success rate, number of attempts, Cormack Lehane score, postoperative sore throat, hoarseness of voice and airway injury as secondary outcome. Results: Analysis of hemodynamic changes showed that the Glidescope decreased hemodynamic response to endotracheal intubation in controlled hypertensive patients with better intubation condition using Cormack Lehane score, first attempts success rate and number of needed trials compared to Macintosh laryngoscope. Also, Glidescope showed less post operative complications as sore throat and hoarseness of the voice; meanwhile, no airway injury happened in both groups. However, Glidescope needed more time for completion of intubation. Conclusions: It could be concluded that using the Glidescope for endotracheal intubation in controlled hypertensive patients in comparison to Macintosh was associated with significant decrease in hemodynamic stress responses, decreased incidence of postoperative sore throat and hoarseness of voice and it improved the endotracheal intubation process.