Comparison of the Effects of Glidescope and Macintosh Laryngoscope Blades on Hemodynamic Changes and Tracheal Intubation Success in Patients with Severe Preeclampsia Candidates for Cesarean Section under General Anesthesia: A Randomized Clinical Trial

Laryngoscopy in women with severe preeclampsia is one of the most stressful anesthesia events; Laryngoscopy can stimulate hemodynamic responses in these women and lead to serious complications; Therefore, it is necessary to choose a safe method for laryngoscopy of these women; the aim of this study is to investigate the safety of Glidescope versus Macintosh blade in tracheal intubation for cesarean delivery in women with severe preeclampsia.

In a controlled prospective clinical trial, 70 pregnant women with severe preeclampsia candidates for cesarean section under general anesthesia were randomly assigned to one of the two groups of 35 Glidescope or Macintosh. Before induction of anesthesia, hemodynamic monitoring including heart rate, pulse oximetry, invasive arterial blood pressure was established. Tracheal intubation was performed in two Glidescope or Macintosh groups with the help of a Glidescope or Macintosh laryngoscope. Hemodynamic parameters were recorded 2 minutes before induction of anesthesia, before laryngoscopy and 1, 2, 3, 4, 5 and 10 minutes after tracheal intubation and compared between two groups.

High blood pressure in the first 5 minutes after intubation was more common in the Mackintosh group (P-value < 0.05). The rate of successful intubation was the same in both groups. The success rate in the first attempt was higher in the glidescope group (88.6% vs. 77.2%). The time required for intubation was longer in the Glidescope group (32.6±50.2 vs. 44.1±29.7 seconds, P - value = 0.03). The rate of airway complications was the same in both groups.

In airway management for cesarean section in a patient with severe pre-eclampsia, intubation with Glidescope, although it requires more time, creates a more acceptable hemodynamic situation than Mcintosh blade; It should be noted that the rate of airway complications is the same in the two groups; Therefore, safety of laryngoscopy with gladoscope in cesarean delivery of women with severe preeclampsia is acceptable.