A randomised comparative study of the effect of Airtraq optical laryngoscope vs. Macintosh laryngoscope on intraocular pressure in non-ophthalmic surgery

Bikramjit Das; Rajiv Kumar Samal; Arup Ghosh; Ratul Kundu

doi:10.1016/j.bjane.2014.07.004

Scientific Article

A randomised comparative study of the effect of Airtraq optical laryngoscope vs. Macintosh laryngoscope on intraocular pressure in non-ophthalmic surgery

Estudo comparativo randomizado do efeito do laringoscópio óptico Airtraq vs. laringoscópio Macintosh sobre a pressão intraocular em cirurgia não oftálmica

Bikramjit Das; Rajiv Kumar Samal; Arup Ghosh; Ratul Kundu

http://dx.doi.org/10.1016/j.bjane.2014.07.004 Braz J Anesthesiol, vol.66, n1, p.19-23, 2016

PDF

Downloads: 0

Abstract

BACKGROUND: We compared intraocular pressure changes following laryngoscopy and intubation with conventional Macintosh blade and Airtraq optical laryngoscope. METHODS: Ninety adult patients were randomly assigned to study group or control group. Study group (n = 45) - Airtraq laryngoscope was used for laryngoscopy. Control group (n = 45) - conventional Macintosh laryngoscope was used for laryngoscopy. Preoperative baseline intraocular pressure was measured with Schiotz tonometer. Laryngoscopy was done as per group protocol. Intraocular pressure and haemodynamic parameters were recorded just before insertion of the device and subsequently three times at an interval of one minute after insertion of the device. RESULTS: Patient characteristics, baseline haemodynamic parameters and baseline intraocular pressure were comparable in the two groups. Following insertion of the endotracheal tube with Macintosh laryngoscope, there was statistically significant rise in heart rate and intraocular pressure compared to Airtraq group. There was no significant change in MAP. Eight patients in Macintosh group had tongue-lip-dental trauma during intubation, while only 2 patients received upper airway trauma in Airtraq group. CONCLUSION: We conclude that Airtraq laryngoscope in comparison to Macintosh laryngoscope results in significantly fewer rises in intraocular pressure and clinically less marked increase in haemodynamic response to laryngoscopy and intubation.

Keywords

Airtraq, Haemodynamic response, Intraocular pressure, Macintosh blade

Resumo

JUSTIFICATIVA: Comparar as alterações de pressão intraocular após laringoscopia e intubação com lâmina Macintosh convencional e laringoscópio óptico Airtraq. MÉTODOS: Noventa pacientes adultos foram randomicamente designados para os grupos estudo ou controle. No grupo estudo (n = 45) o laringoscópio Airtraq foi usado para laringoscopia e no grupo controle (n = 45) o laringoscópio Macintosh convencional foi usado para laringoscopia. A pressão intraocular foi mensurada no pré-operatório com tonômetro Schiotz. A laringoscopia foi feita de acordo com o protocolo de cada grupo. Pressão intraocular e parâmetros hemodinâmicos foram registrados logo antes da inserção do dispositivo e três vezes após a inserção do dispositivo, com intervalo de um minuto. RESULTADOS: As características dos pacientes, os parâmetros hemodinâmicos basais e a PIO basal foram comparáveis nos dois grupos. Após a inserção do tubo endotraqueal com o laringoscópio Macintosh, houve um aumento estatisticamente significativo da frequência cardíaca e da pressão intraocular em comparação com o grupo Airtraq. Não houve alteração significativa da PAM. Oito pacientes do grupo Macintosh sofreram trauma de língua-lábio-dental durante a intubação, enquanto apenas dois pacientes sofreram trauma das vias aéreas superiores no grupo Airtraq. CONCLUSÃO: Concluímos que o laringoscópio Airtraq, em comparação com o laringoscópio Macintosh, resultou em elevações significativamente menores da PIO e em aumentos clinicamente menos acentuados da resposta hemodinâmica à laringoscopia e intubação.

Palavras-chave

Airtraq, Resposta hemodinâmica, Pressão intraocular, Lâmina Macintosh

References

Nishikawa K, Hukuoka E, Kawagishi T. Efficacy of the Airtraq laryngoscope. J Anesth.. 2011;25:93-7.

Dhonneur G, Abdi W, Amathieu R. Optimising tracheal intubation success rate using the Airtraq laryngoscope. Anaes- thesia.. 2009;64:315-9.

Alexander R, Hill R, Lipham WJ. Remifentanyl prevents an increase in intraocular pressure after succinyl choline and tracheal intubation. Br J Anaesth.. 1998;81:606-7.

Prys- Roberts C, Greene LT, Meloche R. Studies of anaesthesia in relation to hypertension: haemodynamic conse- quences of induction and endotracheal intubation. Br J Anaesth.. 1971;43:531-6.

Derbyshire DR, Chmielewski A, Fell D. Plasma cate- cholamine responses to tracheal intubation. Br J Anaesth.. 1983;55:855-9.

Shribman AJ, Smith G, Achola KJ. Cardiovascular and cat- echolamine responses to laryngoscopy with and without intubation. Br J Anaesth.. 1987;59:295-9.

Mostafa SM, Wiles JR, Dowd T. Effects of nebulized lignocaine on the intraocular pressure responses to tracheal intubation. Br J Anaesth.. 1990;64:515-7.

Robinson R, White M, McCann P. Effect of anaesthesia on intraocular blood flow. Br J Ophthalmol.. 1991;75:92-4.

Murphy DF, Eustace P, Unwin A. Intravenous lignocaine pretreatment to prevent intraocular pressure rise following suxamethonium and tracheal intubation. Br J Ophthalmol.. 1986;70:596-8.

Drenger B, Peer J. Attenuation of ocular and systemic responses to tracheal intubation by intravenous lignocaine. Br J Ophthal- mol.. 1987;71:546-8.

Mahajan RP, Grover VK, Sharma SL. Intranasal nitroglyc- erin and intraocular pressure during general anesthesia. Anesth Analg.. 1988;67:631-6.

Kilickan L, Baykara N, Gurkan Y. The effect on intraocular of endotracheal intubation or laryngeal mask airway use during TIVA without the use of muscle relaxants. Acta Anaesthesiol Scand.. 1999;43:343-6.

Langham ME, Kitazawa Y, Hart RW. Adrenergic responses in the human eye. J Pharmacol Exp Therap.. 1971;179:47-55.

Holden R, Morsman CDG, Butler J. Intra-ocular pressure changes using the laryngeal mask airway and tracheal tube. Anaesthesia.. 1991;46:922-4.

Lamb K, James MFM, Janicki PK. The laryngeal mask airway for intraocular surgery: effects on for intraocular pressure and stress responses. Br J Anaesth.. 1992;69:143-7.

Whitford AM, Hone SW, O'Hare B. Intraocular pressure changes following laryngeal mask airway insertion - a compar- ative study. Anaesthesia.. 1997;52:794-6.

Duman A, Ogun CO, Okesli S. The effect on intraocular pressure of tracheal intubation or laryngeal mask airway insertion during sevoflurane anaesthesia in children without the use of muscle relaxants. Paediatr Anaesth.. 2001;11:421-4.

Casati A, Aldegheri G, Fanelli G. Lightwand intuba- tion does not reduce the increase in intraocular pressure associated with tracheal intubation. J Clin Anesth.. 1999;11:216-9.

Tsai PB, Chen B. Haemodynamic responses to endotracheal intu- bation comparing the Airway scope, Glidescope and Macintosh laryngoscope. Internet J Anaesthesiol.. 2010:A24.

Macri FJ. Vascular pressure relationships and the intraocular pressure. Arch Opthalmol.. 1961;65:571-4.

Murphy DF. Anesthesia and intraocular pressure. Anesth Analg.. 1985;64:520-30.

Tsamparlakis J, Casey TA, Howell W. Dependence of intraocular pressure on induced hypotension and pos- ture during surgical anaesthesia. Trans Ophthalmol Soc U K.. 1980;100:521-6.

Bajwa SS, Kaur J, Singh A. Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine. Indian J Anaesth.. 2012;56:123-8.

Petounis AD, Chondreli S, Vadaluka-Sekioti A. Effect of hyper- capnea and hyperventilation on human intraocular pressure during general anaesthesia following acetazolamide administra- tion. Br J Opthalmol.. 1980;64:422-5.

Maassen R, Lee R, van Zundert A. The videolaryngoscope is less traumatic than the classic laryngoscope for a difficult airway in an obese patient. J Anesth.. 2009;23:445-8.

A randomised comparative study of the effect of Airtraq optical laryngoscope vs. Macintosh laryngoscope on intraocular pressure in non-ophthalmic surgery

Estudo comparativo randomizado do efeito do laringoscópio óptico Airtraq vs. laringoscópio Macintosh sobre a pressão intraocular em cirurgia não oftálmica

Bikramjit Das; Rajiv Kumar Samal; Arup Ghosh; Ratul Kundu

Abstract

Keywords

Resumo

Palavras-chave

References

Links

Share

Braz J Anesthesiol