Haemodynamic response to endotracheal intubation using direct laryngoscopy vs. Bonfils retromolar fiberscope: A prospective randomized comparative study

Haemodynamic response to endotracheal intubation using direct laryngoscopy vs. Bonfils retromolar fiberscope: A prospective randomized comparative study - Background and Aims: Direct laryngoscopy (DL) is the traditional method for Endotracheal intubation (ETI), but it often results in more pronounced haemodynamic responses. Bonfils retromolar fiberscope, a more recent alternative, has been proposed as a potentially better option in terms of reducing these responses. This study aimed to compare the haemodynamic effects, time to intubation, and complication rates between these two techniques to determine the optimal approach, especially for patients at risk of cardiovascular complications. Materials and Methods: This prospective randomized comparative study was conducted on 60 patients, randomly allocated to two groups: Group D (n=30) underwent ETI via DL using a Macintosh blade, and Group R (n=30) had ETI via Bonfils retromolar fiberscope. Haemodynamic parameters, including SBP, DBP, MAP, HR, and SpO2, were recorded immediately after ETI and at 1-minute intervals for the next 10 minutes. Procedural complications, such as mucosal injury, lip injury, dental injury, and sore throat, were documented. Time to intubation (TTI) was recorded from the insertion of the laryngoscope or Bonfils to its removal after successful placement of the endotracheal tube (ETT). Results: The haemodynamic response to ETI was significantly higher in Direct laryngoscopy group [P0.05). Conclusion: Bonfils retromolar fiberscope results in a lesser haemodynamic response to tracheal intubation compared to direct laryngoscopy, making it beneficial in patients with cardiovascular diseases. However, the time to intubation is longer with Bonfils, which could decrease with more frequent use due to a longer learning curve. Keywords: Laryngoscopy, Haemodynamic response, Bonfils retromolar fiberscope.