Comparative Evaluation of Hemodynamic Responses and Ease of Intubation with Tuoren Video Laryngoscope Vs Macintosh Laryngoscope in Patients Undergoing Coronary Artery Bypass Graft Surgery

Abstract

Background: Cardiac patients are highly vulnerable to the hemodynamic alterations that follow the laryngoscopy and endotracheal intubation making it beneficial to use methods which can mitigate these effects. This randomized study aimed to compare the efficacy and associated hemodynamic variations between the Macintosh and Tuoren Videolaryngoscope for airway management in patients undergoing coronary artery bypass graftingsurgery.

Method: 60 patients undergoing elective CABG were evenly distributed into Group A (Tuoren Video laryngoscope) and Group B (Macintosh laryngoscope). Hemodynamic parameters, including systolic blood pressure (SBP), diastolicblood pressure (DBP), mean arterial pressure (MAP), pulse rate (PR), rate-pressure product (RPP) and peripheral oxygen saturation (SpO2) were recorded. Laryngoscopy and intubation time, ease of intubation assessed by Krieg’s scale, and intubation difficulty score (IDS) were documented.

Results: There was a greater increase in hemodynamic parameters in group B from 1 minute followingintubation until 5 minutes (p<0.05). Group A provided better glottic visualisation as assessed by CL grade (p<0.05) in significantly shorter laryngoscopy time (p=0.001). Group A had a significantly lower Krieg’s score (p=0.02) and IDS (p=0.04) than group B. The total intubation time, number of attempts, and complications were comparable between both groups, but the need for stylet was higher in group A (p=0.04).

Conclusion: The use of Tuoren video laryngoscope has been associated with faster laryngoscopyand improved glottic visualization, contributing to reduced hemodynamic alterations duringintubation but using a stylet is recommended to enhance the first-attempt successrate during intubation.