Comparison of hemodynamic stress response to laryngoscopy with Video laryngoscopy versus Macintosh laryngoscopy in patients undergoing elective surgeries under general anesthesia

Abstract

Objective: To compare post intubation hemodynamics among patients intubated with video laryngoscope with Macintosh laryngoscope.

Methodology: This single blind randomized control trial included 208 patients was carried out at Department of Anesthesia, Pakistan Institute of Medical Sciences, Islamabad from 22^nd December 2025 to 15^th May 2026. Participants were divided into two groups using computer generated random numbers with group V patients intubated using Video laryngoscope while group M intubated using Macintosh laryngoscope.

Results: The Systolic blood pressure 1 minute after intubation was 139 (137–142.5) in Video laryngoscope group while it was 156 (152.5–158.5) in Macintosh group (p value 0.001). Diastolic blood pressure at 1-minute following intubation in Video laryngoscope was 86 (82.5–90.5) versus 95 (91–102) in Macintosh group (p value <0.001). Mean Blood pressure 1-minute post intubation in group V was 78 (75–82) while group M was 88 (83.5–91) with p value being <0.001. Similarly, blood pressure at 2,3- and 5-minutes following intubation was significantly lower in group V as compared to group M.

Conclusion: Video laryngoscopy reduces the hemodynamic stress response and is associated with significantly lower blood pressure and heart rate as compared to Macintosh laryngoscope following intubation.