Videolaryngoscopy versus direct laryngoscopy in without muscle relaxation intubation conditions in tympanomastoidectomy: A randomized, prospective clinical study

Abstract

Aim: The aim of this study was to compare the effects of direct laryngoscopy and videolaryngoscopy on the intubation conditions and hemodynamic responses, in the patients scheduled for tympanoplasty and mastoidectomy operation and intubated without muscle relaxation. Material and Methods: This randomized, prospective study was performed in 62 patients aged 18-65 years with ASA (American Society of Anesthesiologists) I-II and Mallampati score I-II and scheduled for elective tympanoplasty and mastoidectomy with general anesthesia. The patients were divided into two groups as the direct laryngoscopy group (Group D) and the videolaryngoscopy group (Group V). The induction of anesthesia was performed with 1 mg / kg lidocaine, 3 μg / kg remifentanil and 2.5 mg / kg propofol for both groups. Hemodynamic responses (heart rate, systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure), number of intubation attempts, duration of laryngoscopy, duration of intubation, intubation conditions (degree of coughing, jaw relaxation, ease of laryngoscopy and position of vocal cords), and postoperative hoarseness and sore throat were evaluated. Results: Hemodynamic responses to intubation were similar in both groups. There were no statistically significant differences between the groups in terms of the number of intubation attempts and the duration of laryngoscopy. The duration of intubation was significantly longer in Group V (29.19 sec) than in Group D (22.19 sec). Intubation conditions showed no significant difference between the groups. Conclusion: In patients without intubation difficulty, McGrath® MAC video laryngoscope showed no superiority in intubation conditions compared with Macintosh direct laryngoscope, during intubation without muscle relaxants; the effects on hemodynamic responses were also similar.