Comparison of stress response between conventional laryngoscopy versus video laryngoscopy in patients undergoing general anesthesia.

Abstract

Objective: To compare the hemodynamic stress response between video laryngoscopy and conventional direct laryngoscopy in patients undergoing general anesthesia. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesia, Fauji Foundation Hospital, Rawalpindi. Period: Oct-2025 to Dec-2025. Methods: A total of 192 patients aged 18–50 years, belonging to ASA class I–II and undergoing elective surgery under general anesthesia were randomized into two equal groups. Patients in Group VL underwent video laryngoscopy while patients in Group DL underwent conventional direct laryngoscopy. The primary outcomes were hemodynamic parameters recorded at baseline (T0), during laryngoscopy (T1), at intubation (T2), and at one minute post-intubation (T3). These outcomes were compared between the two groups by applying independent t-test, where a p-value < 0.05 was considered significant. Results: Mean age of patients was 40±7.57 years, ranging from 18 to 50 years with a slightly higher number of male patients (53.13%) compared to the females (46.88%). The results showed an expected increase in HR and BP during laryngoscopy and intubation in both groups; however, analysis of the primary outcomes confirmed that the magnitude of the increase was significantly lower in the VL group compared to the DL group at T1, T2, and T3. Specifically heart rate, systolic blood pressure, diastolic blood pressure and MAP were significantly lower in the video laryngoscopy group at T2 (p< 0.0001). Conclusion: Video laryngoscopy provides a significantly reduced stress response regarding hemodynamic changes compared to conventional laryngoscopy in patients undergoing general anesthesia.