Comparative Study of Stress Response to Intubation between King Vision and Macintosh Laryngoscope in Routine Airway Management

Author(s): Ningthoujam Anita Devi1 , Takhelmayum Hemjit Singh2 , Deitho Koza3 , Nongosal Kirha4 , Raghupathi Ramasamy5 , Shammy Nazarudeen6

BACKGROUND Laryngoscopy and intubation are known to cause exaggerated haemodynamic response and may have deleterious respiratory, neurological and cardiovascular effects. Among the various interventions employed to obtund these responses, the role of King Vision Video Laryngoscope (KVVL) was reported in some studies. So, we would like to compare the haemodynamic responses between the conventional Macintosh laryngoscope and KVVL. METHODS The study was a prospective, randomized one in which 90 adult patients of either sex, aged 18-60 years undergoing elective surgery under general anaesthesia with endotracheal intubation were enrolled in either group of 45 patients each to be subjected to KVVL (Group K) or Macintosh laryngoscope (Group M) for orotracheal intubation. Haemodynamic parameters such as heart rate and blood pressure were recorded every minute for the first 5 minutes after intubation and thereafter every two minutes till the 15th minutes. The time taken for laryngoscopy and intubation were also recorded and P<0.05 was deemed to be significant. RESULTS Demographic parameters such as age, sex, ASA and body mass index were comparable in the two groups (P<0.05). Intubation time was significantly longer in group K (20.74 ± 8.81 sec) as compared to group M (13.23 ± 7.60 sec). The heart rate and mean arterial blood pressure increased from the baseline value to a maximum at around 7th minute post intubation and thereafter receded to approach its baseline value in 15th minute and the difference became significant from the 5th minute onwards till the 15th minute. CONCLUSIONS King Vision Video Laryngoscopy was found to be more effective in reducing haemodynamic responses to laryngoscopy as compared to conventional Macintosh laryngoscopy.