Comparison of efects of direct laryngoscopic endotracheal intubation and fiberoptic endotracheal intubation on intraocular pressure

Objective: In this study; we aimed to compare effects of direct laryngoscopicendotracheal intubation and fiberoptic endotracheal intubation on intraocular pressure. Material and Method: Total of 54 ASA (American Society of Anesthesiologist) 1-2, mallampati 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 III and IV, BMI more than 35, difficult intubation, undergo obstetrical surgery and propofol, fentanyl, rocuronium contraindicated were excluded from the study. Standard DII lead electrocardiography (ECG), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (SpO2) were monitorized and perfusion index (PI) was monitorized by massimo after patient taken into operating theatre. Patients divided randomly into 2 groups as direct laryngoscope intubation group and fiberoptic intubation group. Intravenous line was established and 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 and IOP (intraocular pressure) meaused by same physian from ophtalmology clinic by tonopen were recorded pre induction (basal), after induction, 1 minute after intubation, 2 minutes after intubation, 3 minutes after intubation, 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: Consequently, 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. Key words: Direct laryngoscopy, Fiberoptic intubation, İntraocular pressure