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Comparison of effects of direct laryngoscopic and fiberoptic oral endotracheal intubation on intraocular pressure

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Euroanaesthesia 2017

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Abstract

Objective: In this study; we aimed to compare the effects of direct laryngoscopic and fiberoptic endotracheal intubation on intraocular pressure. Material and Method: Total of 54 ASA (American Society of Anesthesiologist) Grade 1-2, Mallampati score 1 or 2, age between 18 to 65 patient planned to undergo nonophtalmic surgery included to study. Patients with glaucoma, diabetes mellitus, cardiovascular and pulmonary diseases, ASA Grade III and IV, BMI more than 35, difficult intubation, undergo obstetrical surgery and propofol, fentanyl, rocuronium contraindicated were excluded from the study. Patients divided randomly into 2 groups as direct laryngoscopic and fiberoptic intubation group. Patients were preoxigenated with %100 O2 for 3 minutes then anesthesia was induced using propofol 2 mg / kg, fentanyl 1 mcg/kg, and rocuronium 0,5 mg / kg in both groups. After 3 minutes mask ventilation, patients were intubated (women with No:7-7,5, men with No:8-8,5 intubation tube). SBP, DBP, MAP SpO2, PI recorded and IOP (intraocular pressure) measured by ophthalmologist by tonopen were recorded pre-induction (basal), after induction, 1,2,3,5 minutes after intubation, respectively. Period between handling of laryngoscope or fiberoptic device after termination of mask ventilation and obtain end tidal CO2 was accepted as application time and recorded. Study terminated after 5th minute values taken. Results: There was no statistically significant difference in distirubiton of sex, weight, age, height, BMI, MPS and ASA between groups. Duration of intubation was statistically significantly longer in FOB group (p<0,05). Heart rate was statistically significantly higher in DLS group at after induction and 1 minute after intubation compared with FOB group (p<0,05). Statistically significant increase was found in intraocular pressure after 1 minute intubation in DLS group compared with FOB group (p<0,05). Conclusion: We concluded that endotracheal intubation by DLS could be more useful with respesct to endotracheal intubation by FOB patients with patologies accompanying high IOP due to causing significantly less rise in IOP when performed by experienced anesthesiologists.

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© Copyright 2020 Morressier GmbH.
All rights reserved.