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A Comparison of Hemodynamic Changes After Endotracheal Intubation by Using the Lightwand Device and the Laryngoscope in Normotensive and Hypertensive Patients

医学 插管 喉镜检查 麻醉 血流动力学 血压 芬太尼 异丙酚 心率 气管插管 血流动力学反应 内科学
作者
Kohki Nishikawa,Keiichi Omote,Shin Kawana,Akiyoshi Namiki
出处
期刊:Anesthesia & Analgesia [Lippincott Williams & Wilkins]
卷期号:90 (5): 1203-1207 被引量:67
标识
DOI:10.1097/00000539-200005000-00038
摘要

We compared the effects of the lightwand technique on hemodynamic responses, time-to-intubation, number of attempts, and complications during tracheal intubation with those of direct-vision laryngoscopy in normotensive (LN and TN group;n = 20, respectively) and hypertensive (LH and TH group;n = 20, respectively) patients. Lightwand or laryngoscopic oral endotracheal intubation was performed after the induction of anesthesia with fentanyl and propofol and muscle relaxation with vecuronium. Systolic blood pressure, diastolic blood pressure, and heart rate were recorded, and the change from “before intubation” to “immediately after intubation” (ΔP) in each variable was calculated. In normotensive patients, significantly larger ΔP in systolic blood pressure was observed in the LN group than in the TN group (P < 0.05). In hypertensive patients, there were no significant differences between the LH group and the TH group in ΔP after intubation. The time-to-intubation and number of attempts in the lightwand groups were significantly longer and more frequent than those in the laryngoscope groups (P < 0.05). The number of patients who complained of hoarseness was larger in the lightwand groups than in the laryngoscope groups (P < 0.05). We conclude that the lightwand technique significantly attenuates hemodynamic changes after intubation in comparison with the laryngoscopic technique in normotensive patients. However, in hypertensive patients, there is no difference in hemodynamic changes between the two techniques. Implications A lightwand technique was accompanied by less hemodynamic changes after tracheal intubation than the laryngoscopic technique in normotensive patients. In hypertensive patients, however, no difference was found between the two techniques.
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