Evaluation of intra ocular pressure and hemodynamic change following intubation with Maccoy, Macintosh and Video laryngoscope

Abstract

Background & Objective: The induction of anesthesia, laryngoscopy and endotracheal intubation can be associated with adverse hemodynamic response and increased intraocular pressure. The aim of this study was to evaluate intraocular pressure and hemodynamic changes after laryngoscopy and endotracheal intubation with three methods of laryngoscopy (Macintosh, Maccoy and Video laryngoscope).Materials & Methods: One hundred and eighty patients with American Society of Anesthesiology (ASA) classification of I and II, aged 20-70 year, were enrolled in a randomized clinical trial (RCT). Anesthesia was induced by administration of Propofol 2 mg/kg, Fentanyl 1µg/kg and Cisatracurium 0.1mg/kg. the Hemodynamic information of the patients and intraocular pressures were documented and assessed in three stages (after induction of anesthesia and endotracheal intubation, and 5 minutes after endotracheal intubation using Maccoy, Macintosh and Video laryngoscope).Results: Hemodynamic parameters' of patients increased in these three groups compared with those of pre anesthesia measures, but this increase was not significant. Evaluation of intraocular pressure (IOP) in Video laryngoscope group showed that there is a significant drop in intraocular pressure (IOP) compared with other groups. There weren’t any significant differences of IOP after intubation in Maccoy compared to the Macintosh group. Nevertheless there was not any significant difference in IOP, before and five minutes after intubation in these groups.Conclusion: According to a low degree of augment of IOP in Video laryngoscope group and no changes in the Hemodynamic parameters, it seems that the use of Video laryngoscope in eye surgeries might be more suitable for endotracheal intubation.

Keywords

• Hemodynamic responses
• Intraocular pressure
• Laryngoscopy
• Video laryngoscope