Effects of hemodynamic response and endoscopic image scores after intubation with videolaringoscopy that in tympanoplasty and mastoidectomy undergoing surgery of intubation without muscle relaxant

Aim: In our study, we aimed to compare the effects of hemodynamic response after intubation with direct laryngoscopy that tympanoplasty and mastoidectomy undergoing surgery, endoscopic image scores obtained with videolaringoscopy in cases of intubation without muscle relaxant, which we have been using with propofol and remifentanil, the success and duration of intubation, Materials and Methods: Elective tympanoplasty and mastoidectomy surgeon planned to age between 18-65, a total of 63 subjects with ASA I-II and Mallampati score I-II were included in the study. Patients were randomly divided, according to the envelope method into two groups of 30:  Group D; Group to be intubated with direct laryngoscope  Group V; Group to be intubated with videolaryngoscope The patients were monitorised with ECG, noninvasive arterial pressure, SpO2 after they were taken to the operating room. Preoxygenation was performed with face mask for at least 3 minutes with 100 % O2. Anesthesia induction was given for 90 seconds with 1 mg / kg lidocaine and 3 μg / kg remifentanil for 60 seconds and then propofol was administered at 2.5 mg / kg for 30 seconds. Anesthesia was maintained with sevoflurane and 50% oxygen and 50% nitrous oxide. Systolic arterial pressure (SAP), mean arterial pressure (MAP), heart rate (HR) and SpO2 were recorded at baseline, after anesthesia induction and at 1, 3, 5, 10 and 20 minutes after intubation. The entubation conditions of the cases were evaluated according to the Helbo-Hansen Raulo intubation scoring criteria. Cormack-Lehane and Mallampati Scores, number of intubation attempts, laryngeal compression, intubation time were recorded. The incidence of complications due to intubation (oral mucozal bleeding, oesophageal intubation, desaturation), after extubation hoarseness and sore throat were recorded. Results: 63 cases were included in the study. One patient was excluded due to difficult airway observation. 62 cases were evaluated. There was no statistically significant difference between groups D and V in HR. There was no statistically significant difference between Group D and Group V in SAB and OAB after 1, 3, 5, 10 and 20 minutes after intubation. Blood pressure values showed the greatest decrease after induction but increased after intubation but no baseline value. There was a statistically significant difference between groups D (22.19 sec) and Group V (29.19 sec) with respect to the duration of intubation. Conclusion: As a result; When McGRATH® MAC videolaryngoscope compared to Macintosh direct laryngoscop in without muscle relaxant intubation, provide better intubation conditions, similar changes detected in hemodinamic response due to tracheal intubation. Key words: Intubation without muscle relaxant, Laryngoscopy, Hemodynamics, Videolaryngoscopy