Comparison of changes in Serum Cortisol Level During Laryngoscopy And Intubation Using i-view Video Laryngoscope And Machintosh Laryngoscope In Patients Posted For Surgery Under General Anaesthesia.

Laryngoscopy and intubation constitutes to be an important component of general anaesthesia. These have proven to be life saving in many circumstances. However they can also cause changes in the hormonal level and hemodynamics.

Endotracheal intubation has been demonstrated to impose the most intense stress to humans under general anaesthesia. Triggering the physiologic mechanism off causes local inflammation and hypermetabolic process due to the general substrate mobilization and accelerated biochemical reaction. It is also associated with complex stress response characterized by neuro-humoral, immunological and metabolic alterations. Activation of sympathetic nervous system and increased release of catabolic and immuno-suppressive pituitary hormones can be attributable to surgical stress response. In clinical practice, these activations cause changes in heart rate and blood pressure and alterations in biochemical measurements like  cortisol , noradrenalin, adrenalin, and dopamine levels. The type of surgical procedure, either open or laparoscopic, reflects the severity of traumatic stress imposed to the organism. Open surgery may develop much more stress than laparoscopic surgical procedures due to long surgical time, big surgical incision and local and systemic effects.

Recently the use of videolaryngoscopy has become a widely accepted method in both emergency, routine and clinical anaesthesia. Poor vision at laryngoscopy (grade 3-4) is a relatively common finding (10%) even after excluding patients in whom difficult tracheal intubation was anticipated and an alternative technique was chosen. And in many patients there is a need of more than 3 laryngoscopies (1.9%) and failed direct laryngoscopy may occur though it is a rare event(0.1%). Ease of handling, high success rate in patients with normal and difficult airways and a steep learning curves make these devices very popular among physicians. Video laryngoscopes have now been included among first aid devices for the management of difficult situations by Difficult Airway Society (DAS).

i-viewlaryngoscope is among the latest video laryngoscope in current anaesthetic practice It is distributed by the intersurgical company, providing the option of video laryngoscopy wherever you might need to intubate. i-view is ready to use seconds after removing from packaging.The ergonomic design ensures i-view is easy to use and integrated LCD screen provides an optimal view in variety of light conditions.

In the present study, we therefore intend to compare the changes in S.Cortisol level after laryngoscopy and Intubation using the two devices i.e. i-viewand Macintosh laryngoscope