The effect of laryngoscope types on hemodynamic response and optic nerve sheath diameter. McCoy, Macintosh, and C-MAC video-laryngoscope

Saudi Med J. 2020 Sep;41(9):930-937. doi: 10.15537/smj.2020.9.25349.

Abstract

Objectives: This study aims to investigate the effect of McCoy, Macintosh laryngoscope, and C-MAC video-laryngoscopes on optic nerve sheath diameter (ONSD) and hemodynamic responses to laryngoscopy and intubation.

Methods: This prospective randomized study was conducted in Zonguldak Bülent Ecevit University Hospital, Zonguldak, Turkey, between July 2019 and January 2020. Informed written consent was obtained from all patients. Patients with previous intracranial/ocular surgery or glaucoma were excluded from the study. The patients were randomized to use McCoy, Macintosh, and C-MAC (30 per group). Intubations were performed by the same person. Mean arterial pressure, heart rate (HR), and ONSD were recorded before the induction and repeated in 1, 3, 5, and 10 minutes after the intubation.

Results: The effects of laryngoscopy and intubation on hemodynamic responses and ONSD were similar between groups (p greater than 0.05). While the comparison within groups showed ONSD increase in McCoy group and HR and ONSD increase in the Macintosh group compared to baseline 1 min after the intubation, no change was observed in hemodynamic responses and ONSD measurements in the C-MAC® group (p greater than 0.05).

Conclusions: In this study, there was no significant difference between the groups in terms of ONSD and hemodynamic responses to laryngoscopy and intubation. It was observed that there were no significant changes in ONSD values just in C-MAC® video-laryngoscope group. Therefore, intubations with C-MAC® video-laryngoscope are thought to be more appropriate for patients with an increase in intracranial pressure.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Blood Pressure
  • Female
  • Heart Rate
  • Hemodynamics / physiology*
  • Humans
  • Intracranial Hypertension / etiology
  • Intracranial Hypertension / prevention & control
  • Intracranial Pressure
  • Intraocular Pressure
  • Intubation, Intratracheal / adverse effects
  • Intubation, Intratracheal / instrumentation
  • Intubation, Intratracheal / methods
  • Laryngoscopes / adverse effects*
  • Laryngoscopes / classification*
  • Laryngoscopy / adverse effects
  • Laryngoscopy / instrumentation
  • Laryngoscopy / methods
  • Male
  • Middle Aged
  • Optic Nerve / anatomy & histology*
  • Prospective Studies
  • Time Factors