COMPARATIVE EVALUATION OF PERFUSION INDEX TO ENDOTRACHEAL INTUBATION USING MACINTOSH, MCCOY, AND VIDEO LARYNGOSCOPES IN PATIENTS UNDERGOING ELECTIVE SURGERY UNDER GENERAL ANESTHESIA
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Keywords
Perfusion index, laryngoscopes, patients, endotracheal intubation, hemodynamic, laryngoscopy
Abstract
Background: Laryngoscopy and endotracheal intubation provoke hemodynamic responses due to sympathetic stimulation, which may be detrimental especially in patients with cardiovascular comorbidities. The perfusion index (PI), a non-invasive marker of peripheral perfusion, has emerged as a potential indicator of stress response during intubation. This study aimed to compare the changes in PI and hemodynamic parameters following intubation using Macintosh, McCoy, and Tuoren video laryngoscopes (VLHM5A, Tuoren Medical Device India Pvt. Ltd.) and to assess their correlation.
Methods: A prospective, randomized study was conducted in 135 ASA I–II patients undergoing elective surgery under general anesthesia. Patients were assigned to three groups (n=45 each): Group A (Macintosh), Group B (McCoy), and Group C (video laryngoscope). Perfusion index (PI), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at baseline, post-induction, and up to 10 minutes post-intubation. Correlation coefficients between PI and hemodynamic variables were analyzed.
Results: Groups B and C demonstrated significantly higher PI values compared to Group A post-intubation (p<0.05). Group A showed the highest rise in SBP, DBP, MAP, and HR. A significant negative correlation was observed between PI and HR in Group A at 6–10 minutes and with DBP and MAP in Groups B and C in early intervals (p<0.05). Minor complications were minimal.
Conclusion: The McCoy and Macintosh laryngoscopes were associated with minimal hemodynamic fluctuation and better maintenance of PI, indicating reduced stress response.
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Dr. Dipali Taneja
Senior Specialist, Department of Anesthesiology, Deen Dayal Upadhyay Hospital, New Delhi, India
Dr. Shrikanta
Senior Resident, Department of Anesthesiology & Critical Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi
Dr. Susmita Sarangi
Consultant, Department of Anesthesiology, Deen Dayal Upadhyay Hospital, New Delhi, India
Dr Shah Raj Jayantilal
Senior Resident, Department of Anesthesiology, Vallabhbhai Patel Hospital, New Delhi