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. Jan-Feb 2016;32(1):35-9.
doi: 10.12669/pjms.321.9044.

Double-lumen Tube Intubation Using Video Laryngoscopy Causes a Milder Cardiovascular Response Compared to Classic Direct Laryngoscopy

Free PMC article

Double-lumen Tube Intubation Using Video Laryngoscopy Causes a Milder Cardiovascular Response Compared to Classic Direct Laryngoscopy

Wei Wei et al. Pak J Med Sci. .
Free PMC article


Objective: To determine whether there is a clinically relevant difference between the circulatory responses to double-lumen tube intubation (DLTI) with the GlideScope video laryngoscope versus the Macintosh direct laryngoscope.

Methods: Eighty adult patients requiring double-lumen tubes for thoracic surgery were randomly and equally allocated to either a Macintosh direct laryngoscope group (DL group, n = 40) or a Glide Scope video laryngoscope group (GS group, n = 40). DLTI was performed after airway evaluations and induction of anesthesia. Systolic blood pressure (SBP) and heart rate (HR) were recorded before induction (baseline values), immediately before intubation (post-induction values), at intubation and after intubation. Rate-pressure-product (RPP), and the areas under SBP- and HR-time curves were calculated. All data obtained by the two devices were compared.

Results: After laryngoscope insertion, SBP of DL and GS groups changed significantly differently (13.1% vs. 4.6%, P< 0.001), while HR changed similarly (17.2% vs. 14.6%, P = 0.074). One minute after intubation, both SBP and HR significantly increased in both groups (SBP: 11.6% vs. 11.9%; HR: 18.4% vs. 10.8%), but there were no significant differences between the two groups. RPP significantly increased in both groups after laryngoscope insertion (32.6%, P=0.001; 18.2%, P=0.002), and there was a significant difference between the two groups (P =0.001). Throughout intubation, the areas under SBP-time curves had a significant difference between the two groups (P = 0.042), while those under HR-time curves did not differ significantly (P=0.06).

Conclusion: The intubation response was most significant upon laryngoscope insertion during the whole intubation process. The GlideScope video laryngoscope induced milder circulatory fluctuations than the Macintosh direct laryngoscope did, suggesting that DLTI using video laryngoscopy can help reduce the cardiovascular response to intubation.

Keywords: Double-lumen tube; Hemodynamic response; Intubation; Video laryngoscope.


SBP at different time points.
HR at different time points.
RPP at different time points.

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    1. Cheney FW, Posner KL, Lee LA, Caplan RA, Domino KB. Trends in anesthesia-related death and brain damage: A closed claims analysis. Anesthesiology. 2006;105(6):1081–1086. - PubMed
    1. Cooper RM. Use of a new videolaryngoscope (GlideScope) in the management of a difficult airway. Can J Anaesth. 2003;50(6):611–613. - PubMed
    1. Agro F, Barzoi G, Montecchia F. Tracheal intubation using a Macintosh laryngoscope or a GlideScope in 15 patients with cervical spine immobilization. Br J Anaesth. 2003;90(5):705–706. - PubMed
    1. Sun DA, Warriner CB, Parsons DG, Klein R, Umedaly HS, Moult M. The GlideScope Video Laryngoscope: randomized clinical trial in 200 patients. Br J Anaesth. 2005;94(3):381–384. - PubMed
    1. Thorley DS, Simons AR, Mirza O, Malik V. Palatal and retropharyngeal injury secondary to intubation using the GlideScope(R) video laryngoscope. Ann R CollSurg Engl. 2015;97(4):e67–69. doi:10.1308/003588415X14181254789727. - PMC - PubMed

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