Randomized Prospective Comparison of Glidescope Video Laryngoscope with Macintosh Laryngoscope in Adult who Underwent Thyroid or Parathyroid Surgery Using Neuromonitorization
Murat Güneş1, Ayse Surhan Cinar2, Mehmet Uludag31Department of Anesthesiology Intensive Care Unit, Izmir Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey2Department of Anesthesiology and Reanimation, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Resarch Hospital, Istanbul, Turkey
3Department of Anesthesiology and Reanimation, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Resarch Hospital; Department of General Surgery, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Resarch Hospital, Istanbul, Turkey
Objectives: The present study aims to compare the effects of Glidescope Video Laryngoscope (GVL) and Machintosh Laryngoscope (ML) on the hemodynamic response, intubation time and mucosal damage in adult patients who underwent thyroid or parathyroid surgery using neuromonitorization.
Methods: In this study, 180 patients, aged between 22 and 65 classified as Class I-II in ASA (American Society of Anesthesiologists) and operated under elective conditions were included. Patients were assigned into two groups: Patients intubated with GVL Group G (n=90) and patients intubated with ML Group M (n=90). In both groups, intubation time and the number of trials were recorded. HR (Heart Rate), SpO2 (Peripheral Capillary Oxygen Saturation), SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure) and MBP (Mean Blood Pressure) scores were recorded at preinduction, post-induction, post-intubation and three minutes after intubation. Post-operative intubation-associated complications were recorded.
Results: Post intubation HR, DBP and MBP scores were found to be significantly higher in Group M than Group G (p=0,006, p=0.013, p=0.011). Intubation time was found to be significantly higher in Group G than in group M (35.3±10.3, 22.1±7.7 sec). There was no significant difference between the groups’ number of trials and intubation-associated complications.
Conclusion: Despite its long intubation time, we believe that GVL may be the first choice laryngoscopy method in the thyroid or parathyroid cases that intubated with a low dose muscle relaxant for neuromonitoring since it has a slight effect than ML on hemodynamism it does not increase mucosal damage and has improved visibility.
Erişkinlerde nöromonitorizasyon tüpü kullanilan tiroid ve paratiroid vakalarinda glidescope video laringoskopun macintosh laringoskop ile randomize prospektif karşilaştirilmasi
Murat Güneş1, Ayse Surhan Cinar2, Mehmet Uludag31Department of Anesthesiology Intensive Care Unit, Izmir Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey2Department of Anesthesiology and Reanimation, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Resarch Hospital, Istanbul, Turkey
3Department of Anesthesiology and Reanimation, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Resarch Hospital; Department of General Surgery, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Resarch Hospital, Istanbul, Turkey
Introduction and Aim: The aim of this study was to compare the effects of Glidescope Video Laryngoscope (GVL) and Machintosh Laryngoscope (ML) on hemodynamic response, intubation time and mucosal damage in adult patients who underwent thyroid or parathyroid surgery using neuromonitorization.
Materials and Methods: A total of 180 patients, aged between 22 and 65 classified as Class I-II in ASA (American Society of Anesthesiologists) and operated under elective conditions were included in the study. Patients were assigned into two groups: those intubated with GVL Group G (n: 90) and those intubated with ML Group M (n: 90). In both groups intubation time and number of trials were recorded. HR (Heart Rate), SpO2 (Peripheral Capillary Oxygen Saturation), SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure) and MBP (Mean Blood Pressure) scores were recorded at preinduction, post-induction, post-intubation and 3 minutes after intubation. Post-operative intubation-associated complications recorded.
Results: Post intubation HR, DBP and MBP scores were found to be significantly higher in Group M than Group G (p=0,006, p = 0.013, p = 0.011). Intubation time was found to be significantly higher in Group G than in group M (35.3 ± 10.3, 22.1 ± 7.7 sec). There was no significant difference between the groups number of trials and intubation-associated complications.
Giriş ve Amaç: Bu çalışmanın amacı, Glidescope Video Laringoskop (GVL) ve Machintosh Laringoskop'un (ML) erişkin hastalarda nöromonitorizasyon uygulanan tiroid veya paratiroid vakalarında hemodinamik yanıt, entübasyon süresi ve mukozal hasar üzerindeki etkilerini karşılaştırmaktı.
Gereç ve Yöntem: Çalışmaya, 18–65 yaş arasında, ASA (American Society of Anesthesiologists) I-II sınıfında, elektif şartlarda opere olan 180 hasta dahil edildi. GVL ile entübe edilenler grup G (n: 90), ML ile entübe edilenler grup M (n: 90) olmak üzere hastalar iki gruba ayrıldı. Her iki grupta entübasyon süresi ve deneme sayısı kaydedildi. Preindüksiyon, postindüksiyon, postentübasyon sonrası hemen ve entübasyondan sonraki 3. dakikadaki KTA (Kalp Tepe Atımı), Spo2 (Periferik oksijen satürasyonu), SAB (Sistolik Arter Basıncı), DAB (Diyastolik Arter Basıncı) ve OAB (Ortalama Arter Basıncı) değerleri kaydedildi. Ameliyat sonrası entübasyonla ilişkili komplikasyonlar kaydedildi.
Bulgular:
Entübasyon sonrası KTA, SAB ve OAB skorları Grup M'de Grup G'ye göre anlamlı derecede yüksek bulundu (p = 0,006, p = 0,013, p = 0,011). Entübasyon süresi Grup G'de grup M'ye göre anlamlı derecede yüksek bulundu (35.3 ± 10.3, 22.1 ± 7.7 sn). Gruplar arasında deneme sayısı ve entübasyonla ilişkili komplikasyonlarda anlamlı fark yoktu.
Sonuç: GVL’nin uzun entübasyon süresine rağmen geliştirilmiş görünürlüğü sayesinde hemodinamiye daha az olan etkisinden ve mukozal hasarlanmayı artırmamasından dolayı nöromonitorizasyon için düşük doz kas gevşetici ile entübe edilen tiroid veya paratiroid vakalarında ilk tercih laringoskopi yöntemi olabileceği kanaatindeyiz. (SETB-2020-06-095)
Manuscript Language: English