Comparing Hemodynamic Responses to Intubation in Hypertensive Patients: Clearvue® Video Laryngoscope Versus Macintosh Direct Laryngoscope

Introduction: The ClearVue® video-laryngoscope (CVL) is believed to alleviate the stress response associated with intubation by providing superior laryngeal views, minimizing oropharyngo-laryngeal stimulation, and potentially reducing the pressor response. Objective: This study aims to assess and...

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Main Authors: Ram Kishan Vyas, Sunita Meena, Jai Sharma, Ritesh Kumar Sompura
Format: Article
Language:English
Published: Universitas Airlangga, Faculty of Medicine 2025-07-01
Series:Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Subjects:
Online Access:https://e-journal.unair.ac.id/IJAR/article/view/61761
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author Ram Kishan Vyas
Sunita Meena
Jai Sharma
Ritesh Kumar Sompura
author_facet Ram Kishan Vyas
Sunita Meena
Jai Sharma
Ritesh Kumar Sompura
author_sort Ram Kishan Vyas
collection DOAJ
description Introduction: The ClearVue® video-laryngoscope (CVL) is believed to alleviate the stress response associated with intubation by providing superior laryngeal views, minimizing oropharyngo-laryngeal stimulation, and potentially reducing the pressor response. Objective: This study aims to assess and compare how effective and safe intubation is when using a CVL versus a Macintosh direct laryngoscope (MDL) in patients with high blood pressure who are having surgery. Methods: This prospective, randomized, interventional study was conducted on 140 hypertensive patients on antihypertensive medication undergoing elective surgery under general anesthesia (GA), who were allocated into two groups, CVL group (n = 70) and MDL group (n = 70). Hemodynamic parameters, including mean arterial pressure (MAP), mean heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP), were monitored at baseline, induction, and at various intervals post-intubation (1, 2, 3, 4, 5, and 10 minutes). Other metrics, such as intubation time, intubation attempts, ease of intubation, and associated complications, were documented. Results: Significant differences in heart rate were observed between the groups, right at intubation and at 1, 2, and 3 minutes post-intubation (p-values: 0.011; 0.028; 0.002; 0.003). SBP showed significant differences at intubation and during the first four minutes post-intubation (p-values < 0.001 except for the fourth minute, p = 0.001). DBP and MBP also showed significant differences at various intervals post-intubation (p-values < 0.001 to 0.025 and < 0.001 to 0.020, respectively). No significant difference in airway complications was noted. Conclusion: The CVL offers advantages over MDL in patients with controlled hypertension, specifically in reducing hemodynamic changes during intubation without increasing airway complications. At the same time, MDL offered less intubation time overall than CVL.
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publisher Universitas Airlangga, Faculty of Medicine
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series Indonesian Journal of Anesthesiology and Reanimation (IJAR)
spelling doaj-art-180e1300e00a4a27bd858b390179ccb22025-08-20T03:09:44ZengUniversitas Airlangga, Faculty of MedicineIndonesian Journal of Anesthesiology and Reanimation (IJAR)2722-45542686-021X2025-07-0172768410.20473/ijar.V7I22025.76-8459928Comparing Hemodynamic Responses to Intubation in Hypertensive Patients: Clearvue® Video Laryngoscope Versus Macintosh Direct LaryngoscopeRam Kishan Vyas0https://orcid.org/0009-0007-6880-5867Sunita Meena1https://orcid.org/0009-0004-4415-6960Jai Sharma2https://orcid.org/0009-0008-3423-7221Ritesh Kumar Sompura3https://orcid.org/0009-0005-2913-2810Department of Anesthesia, Swai Man Singh Medical College, JaipurDepartment of Anesthesia, Swai Man Singh Medical College, JaipurDepartment of Anesthesia, Swai Man Singh Medical College, JaipurDepartment of Anesthesia, Swai Man Singh Medical College, JaipurIntroduction: The ClearVue® video-laryngoscope (CVL) is believed to alleviate the stress response associated with intubation by providing superior laryngeal views, minimizing oropharyngo-laryngeal stimulation, and potentially reducing the pressor response. Objective: This study aims to assess and compare how effective and safe intubation is when using a CVL versus a Macintosh direct laryngoscope (MDL) in patients with high blood pressure who are having surgery. Methods: This prospective, randomized, interventional study was conducted on 140 hypertensive patients on antihypertensive medication undergoing elective surgery under general anesthesia (GA), who were allocated into two groups, CVL group (n = 70) and MDL group (n = 70). Hemodynamic parameters, including mean arterial pressure (MAP), mean heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP), were monitored at baseline, induction, and at various intervals post-intubation (1, 2, 3, 4, 5, and 10 minutes). Other metrics, such as intubation time, intubation attempts, ease of intubation, and associated complications, were documented. Results: Significant differences in heart rate were observed between the groups, right at intubation and at 1, 2, and 3 minutes post-intubation (p-values: 0.011; 0.028; 0.002; 0.003). SBP showed significant differences at intubation and during the first four minutes post-intubation (p-values < 0.001 except for the fourth minute, p = 0.001). DBP and MBP also showed significant differences at various intervals post-intubation (p-values < 0.001 to 0.025 and < 0.001 to 0.020, respectively). No significant difference in airway complications was noted. Conclusion: The CVL offers advantages over MDL in patients with controlled hypertension, specifically in reducing hemodynamic changes during intubation without increasing airway complications. At the same time, MDL offered less intubation time overall than CVL.https://e-journal.unair.ac.id/IJAR/article/view/61761blood pressureclearvue® video-laryngoscopehemodynamic responsemacintosh laryngoscope
spellingShingle Ram Kishan Vyas
Sunita Meena
Jai Sharma
Ritesh Kumar Sompura
Comparing Hemodynamic Responses to Intubation in Hypertensive Patients: Clearvue® Video Laryngoscope Versus Macintosh Direct Laryngoscope
Indonesian Journal of Anesthesiology and Reanimation (IJAR)
blood pressure
clearvue® video-laryngoscope
hemodynamic response
macintosh laryngoscope
title Comparing Hemodynamic Responses to Intubation in Hypertensive Patients: Clearvue® Video Laryngoscope Versus Macintosh Direct Laryngoscope
title_full Comparing Hemodynamic Responses to Intubation in Hypertensive Patients: Clearvue® Video Laryngoscope Versus Macintosh Direct Laryngoscope
title_fullStr Comparing Hemodynamic Responses to Intubation in Hypertensive Patients: Clearvue® Video Laryngoscope Versus Macintosh Direct Laryngoscope
title_full_unstemmed Comparing Hemodynamic Responses to Intubation in Hypertensive Patients: Clearvue® Video Laryngoscope Versus Macintosh Direct Laryngoscope
title_short Comparing Hemodynamic Responses to Intubation in Hypertensive Patients: Clearvue® Video Laryngoscope Versus Macintosh Direct Laryngoscope
title_sort comparing hemodynamic responses to intubation in hypertensive patients clearvue r video laryngoscope versus macintosh direct laryngoscope
topic blood pressure
clearvue® video-laryngoscope
hemodynamic response
macintosh laryngoscope
url https://e-journal.unair.ac.id/IJAR/article/view/61761
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AT jaisharma comparinghemodynamicresponsestointubationinhypertensivepatientsclearvuevideolaryngoscopeversusmacintoshdirectlaryngoscope
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