Effects of lidocaine and esmolol on hemodynamic response to tracheal intubation: a randomized clinical trial

A pesar de los avances tecnológicos y el desarrollo de habilidades no técnicas, las muertes prevenibles por fallas en el manejo avanzado de la vía aérea aún son un problema en la atención del paciente inestable. Una de las estrategias descritas para mejorar el porcentaje de éxito de la intubación al primer intento, y posiblemente disminuir complicaciones, es la secuencia rápida de inducción e intubación, una intervención compleja que requiere preparación del personal de salud. Desde su descripción original han existido profundizaciones, nuevas intervenciones y cambios, por lo que existe la necesidad de hacer una síntesis de estas evidencias. En este artículo se presenta una revisión narrativa sobre el tema basada en una búsqueda no sistemática, la cual resultó en una aproximación a las acciones e intervenciones más representativas a criterio de los autores, resaltando la valoración de la vía aérea, la preparación de los equipos críticos, el adecuado posicionamiento según el tipo de población, las estrategias de preoxigenación, la preestabilización de la causa subyacente, el resumen de los medicamentos inductores y relajantes neuromusculares, las estrategias alternas de intubación, como la videolaringoscopia, y los cuidados posintubación, que incluyen la estrategia de fijación de doble vector y parámetros iniciales de ventilación.

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“…Reducir la incidencia de taquicardia y controlar la frecuencia cardiaca inmediatamente después de la intubación traqueal (35).…”

Section: Betabloqueadoresunclassified

Secuencia rápida de inducción e intubación: una revisión narrativa

Martínez-Hurtado

Aristizábal-Hincapié²,

Zamudio³

2022

Iatreia

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“…Laryngoscopy and tracheal intubation can cause increases in BP, heart rate (HR), and IOP due to stimulation of the autonomic nervous system and the release of stress hormones such as adrenaline. These changes are generally considered normal physiological responses [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Does Practitioner Experience Affect Intraocular Pressure After Endotracheal Intubation?

Başkan¹,

Başkan²

2023

Cureus

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Aim: Intraocular pressure (IOP) may decrease or increase during general anesthesia, depending on various factors. This study aimed to investigate the effects of the level of provider training period on post-intubation IOP values and hemodynamic response. Methods: This study was a cross-sectional observational study. Before inclusion in the study, informed consent was obtained from all participants. The study was approved by the local ethical committee. The study included 120 adult patients, both sexes, aged between 18 and 65, with physical statuses according to the American Society of Anesthesiologists (ASA) I or II, Mallampati score I. The research included 120 anesthesiologist resident doctors who received their training in our clinic. In this study, anesthesiology resident doctors were divided into three separate seniority groups (group 1, less than one-year residents in anesthesiology who had performed fewer than 10 intubations; group 2, one- to three-year residents; and group 3, more than three-year residents). After receiving a standard intravenous induction, direct laryngoscopy and endotracheal intubation techniques were performed. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and IOP were measured and recorded before pre-induction (T1), the first minute after induction (T2), and the first minute after laryngoscopy and intubation (T3). Results: There was no statistically significant difference (p > 0.05) between groups in the values of IOP, SBP, DBP, and HR measured at T1, T2, and T3. Measurements at T1, T2, and T3 were similar in all three groups. Comparisons within the groups revealed that IOP values at all measurement times (T1, T2, and T3) were different from each other in less than three-year resident groups. This difference was statistically significant (p < 0.001). The measurement values at T2 were the lowest and T3 were the highest in less than three-year resident groups. There was a significant increase in IOP after endotracheal intubation (T3) compared to baseline levels (T1) in less than three-year resident groups. IOP values at T2 were also significantly lower than the values at T1 and T3 (p < 0.001) in the more than three-year resident group (group 3). However, when we compared IOP measurements at T1 and T3 among themselves in the more than three-year resident group, no significant difference was found (p > 0.05). Conclusion: This study showed that endotracheal intubation in general anesthesia practice is performed most effectively by resident doctors with more than three years of anesthesiology training, without changing the IOP value.

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Effects of lidocaine and esmolol on hemodynamic response to tracheal intubation: a randomized clinical trial

Cited by 2 publications

References 22 publications

Secuencia rápida de inducción e intubación: una revisión narrativa

Secuencia rápida de inducción e intubación: una revisión narrativa

Does Practitioner Experience Affect Intraocular Pressure After Endotracheal Intubation?

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