Discussion
arrhythmia, orotracheal intubation, heart complications, ®
ARRHYTHMIA, COMPLICATIONS, VENTRICULAR EXTRASYSTOLES
We conducted a prospective randomized clinical trial to evaluate the hemodynamic impact of orotracheal intubation by McGrath® compared to the Macintosh laryngoscope in the elderly patients proposed for a scheduled surgery under general anesthesia with orotracheal intubation. We included 60 patients and divided them into 2 equivalent groups: patients who were intubated using the McGrath® (group V) and patients who were intubated using the Macintosh direct laryngoscope (group M). This study showed that the McGrath® videolaryngoscope decreased hemodynamic fluctuations and complications due to endotracheal intubation in elderly patients with fewer heart complications or postoperative laryngeal morbidities.Over the last few decades, several studies listed in the anesthesia literature have addressed the hemodynamic impact of laryngoscopy and orotracheal intubation. In 1951, King In our study, the intubation time obtained with the McGrath® was greater than that obtained with the Macintosh laryngoscope. In a study of 120 patients, Kaur Mechanical stimulation of pharyngeal and laryngeal proprioceptors during laryngoscopy and tracheal intubation induces the secretion of cortisol and catecholamines, and therefore a subsequent increase in HR (by about 20%), blood pressure (BP) (40-50%), pulmonary capillary pressure (Pcap) and intracranial pressure (ICP) [We noted a tendency for arrhythmia (ventricular extrasystoles) in group M when compared to group V. This may be due to a greater adrenergic discharge caused by Macintosh laryngoscopy, related to the intensity of the force applied [