Comparative Evaluation of Hemodynamic Responses and Ease of Intubation with Airtraq Video Laryngoscope versus Macintosh Laryngoscope in Patients with Ischemic Heart Disease

INTRODUCTION: Hemodynamic responses during laryngoscopy can potentially precipitate ischemia in patients with coronary artery disease. There are conflicting reports regarding the hemodynamic stress responses between the conventional Macintosh and video laryngoscopes. There is a paucity of studies regarding the same in cardiac surgical patients. MATERIALS AND METHODS: A prospective, randomized control study to compare the hemodynamic responses and ease of intubation using Airtraq video laryngoscope and Macintosh laryngoscope in patients with ischemic heart disease. RESULTS: Seventy patients were randomized into two groups. Baseline variables including age, weight, Mallampati score, and comorbidities were comparable between the two groups. There was statistically significant elevation in mean heart rate in the Macintosh group at 2(nd)-min (P = 0.02) and 3(rd)-min (P = 0.05) postintubation. Similarly, there was a significant increase in mean arterial pressure at 2(nd) (P = 0.06), 3(rd) (P = 0.03), and 4(th) (P = 0.03) in the Macintosh group. The time for laryngoscopy and Intubation Difficulty Scale was significantly better in the Airtraq group (P = 0.001 and 0.001). However, the median time to intubation was longer in the Airtraq group (13 s vs. 11 s, P = 0.05). Laryngoscopy view was better with Airtraq even in patients with Mallampati score 3 (ten patients). The incidence of trauma was same in both the groups. CONCLUSION: Airtraq provides the better hemodynamic stability and ease of intubation and may be considered superior to conventional Macintosh laryngoscope for intubation in patients with ischemic heart disease.