Comparison of haemodynamic responses to orotracheal intubation in anaesthetised and paralysed patients with simulated cervical spine injury: Airtraq® video laryngoscope versus Fibreoptic bronchoscope

Background: Endotracheal intubation may produce haemodynamic fluctuations which may be deleterious in patients with cardiovascular and neurological disorders. This is further worsened in patients with difficult airway. This study was conducted to compare haemodynamic fluctuations produced when intubation was done using Airtraq and fibreoptic bronchoscopy which are used in patients with anticipated difficult airway.

Methodology: Prospective randomized study. Eighty patients, ASA PS 1 and 2 undergoing elective surgery were randomized into two groups – Group A and Group F. After routine induction and muscle relaxation, orotracheal intubation was done using Airtraq in Group A and fibreoptic bronchoscope in Group F. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded at regular intervals. Duration and number of attempts for intubation were also noted

Results: There was no significant difference in the average of variation in HR (p=0.384), SBP (p=0.179), DBP (p=0.746) and MAP (p=0.057) from the baseline between the two groups. Duration of intubation in FOB group (mean value of 56.98 s) was more than Airtraq® video laryngoscope group (mean value of 37.38 s) which was statistically significant.

Conclusion: Use of fibreoptic bronchoscope offer no added advantage over Airtraq video laryngoscope in terms of haemodynamic response for intubation in difficult airway situation such as cervical spine injury.