Blood pressure and heart rate changes during intubation: a comparison of direct laryngoscopy and a fibreoptic method

Xue, Fu‐Shan; Zhang, G. H.; Sun, Haitao; Li, C. W.; Li, P.; Liu, K. P.; Xu, Yuan-Chen; Liu, Y.

doi:10.1111/j.1365-2044.2006.04584.x

Cited by 28 publications

(16 citation statements)

References 19 publications

(22 reference statements)

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“…Maximum increase in heart rate and mean arterial blood pressure was at the end of endotracheal intubation (Table 2). Our results are in consistence with the results of Singh et al [4], Finfer et al [5] and Xue et al [6] which showed significant rise in heart rate and blood pressure during and after nasotracheal intubation.…”

Section: Discussionsupporting

confidence: 93%

Comparison of Hemodynamic Response and Complications in Patients with Difficult Airway Using Two Techniques-Retrograde and Fibreoptic Intubation

Singh¹,

Paswan²,

Meena³

et al. 2017

J Anesth Clin Res

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Objective: The Aim of this study was to identify the hemodynamic response and success rate to awake retrograde endotracheal intubation (REI) and fiberoptic bronchoscope (FOB) assisted endotracheal intubation in difficult airway situation and to validate whether the REI can attenuate the hemodynamic response to tracheal intubation compared with the FOB assisted intubation. Design: Randomized Prospective Study.Methods: 64 adults, ASA I-II scheduled for elective surgery requiring endotracheal intubation were randomly allocated to either the awake REI group (n=32) or the FOB group (n=32). Non-invasive blood pressure (NIBP), heart rate (HR) and Spo 2 were recorded. Time taken for intubation and success rate of intubation during the observation was also recorded.Results: During awake intubation, the magnitude of change of both NIBP and HR was greatest in Group REI as compare to Group FOB. Time taken for intubation and success rate were better in FOB group, while complication like airway trauma was higher in awake retrograde intubation group (REI).Conclusions: Awake Endotracheal intubation using FOB and REI in adult may cause increases in MAP and HR. However we observed maximum increase in heart rate and MAP occurred at the end of intubation in REI group than FOB, while time taken for intubation were lesser and success rate of intubation were superior in FOB as compare to REI group.

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Section: Discussionsupporting

confidence: 93%

Comparison of Hemodynamic Response and Complications in Patients with Difficult Airway Using Two Techniques-Retrograde and Fibreoptic Intubation

Singh¹,

Paswan²,

Meena³

et al. 2017

J Anesth Clin Res

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“…(14) When Xue et al compared nasal FOI with direct laryngoscopy for asleep nasal tracheal intubation, they found that nasal FOI was associated with significantly higher mean systolic blood pressure (126.9 ± 21.6 mmHg vs. 108.8 ± 11.1 mmHg, respectively) and heart rate (100.5 ± 16.4 bpm vs. 87.6 ± 17.9 bpm, respectively) compared with baseline values (similar for both groups). (15) The higher systolic blood pressure and heart rate occurred despite avoidance of direct stimulation of the tongue base during nasal FOI, thereby minimising gagging and its associated pressor response. The patients had no airway topicalisation.…”

Section: Airway Complicationsmentioning

confidence: 99%

“…The cardiovascular responses during FOI were attributed to prolonged intubation times (the resulting hypercarbia causes a rise in blood pressure and heart rate, but the authors considered this a minor contributory factor), FOI stimulation of the oropharyngeal structures, and jaw thrust. (15)…”

Section: Airway Complicationsmentioning

confidence: 99%

Fibreoptic intubation in airway management: a review article

Wong¹,

Lee²,

Wong³

et al. 2019

smedj

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Since the first use of the flexible fibreoptic bronchoscope, a plethora of new airway equipment has become available. It is essential for clinicians to understand the role and limitations of the available equipment to make appropriate choices. The recent 4th National Audit Project conducted in the United Kingdom found that poor judgement with inappropriate choice of equipment was a contributory factor in airway morbidity and mortality. Given the many modern airway adjuncts that are available, we aimed to define the role of flexible fibreoptic intubation in decision-making and management of anticipated and unanticipated difficult airways. We also reviewed the recent literature regarding the role of flexible fibreoptic intubation in specific patient groups who may present with difficult intubation, and concluded that the flexible fibrescope maintains its important role in difficult airway management.

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“…Airway manipulations such as laryngoscopy and naso or oropharyngeal intubation during general anesthesia are considered noxious stimuli that result in undesirable responses as tachycardia, hypertension, arrhythmia, pulmonary hypertension, and increased airway reactivity. Laryngoscopy causes at least 20 mmHg increase in systolic blood pressure [1]. Intracranial pressure increases at least 5 mmHg with simple tracheal suction [2].…”

Section: Introductionmentioning

confidence: 99%

Bispectral index guided attenuation of hemodynamic and arousal response to endotracheal intubation using magnesium sulfate and fentanyl. Randomized, controlled trial

Megalla

Abdou

Mohamed

2019

Egyptian Journal of Anaesthesia

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Objectives: Airway manipulations induce marked fluctuations in heart rate and blood pressure. Strict narcotic legislations limit availability of fentanyl. This study was designed to compare the attenuating effects of intravenous magnesium sulfate with fentanyl on cardiovascular and arousal response following laryngoscopy and intubation, while ensuring anesthetic depth with Bispectral index monitoring. Methods: Seventy-five female patients ASA 1 or 2, scheduled for elective surgery under general anesthesia were randomized into three groups: Group M received 40 mg/kg magnesium sulfate, Group F, 2 μg/kg fentanyl, and Group C received saline prior to induction of anesthesia. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), and bispectral index (BIS) were measured at various time points. Maximum change in hemodynamic parameters and arousal response were calculated (ΔSBP, ΔDBP, ΔHR, ΔBIS). Adverse effects related to study drugs were recorded. Results: There was a statistically significant increase in BP and HR following intubation in all three groups compared to prelaryngoscopy levels. ΔSBP and ΔDBP were comparable in M and F groups, but p < 0.000 when compared with control group. Following infusion of the study drug, HR increased in M group p = 0.002, while decreased in F group, p < 0.001. BIS also increased significantly after intubation compared to prelaryngoscopy levels, ΔBIS was 9.2 (SD 2.4)%, 9.9 (1.9)% in F and M groups compared to 31.8 (7.8) in group C, p < 0.000. Hypertension, although transient, occurred in 44% in control group compared to none in other groups. Conclusion: Magnesium sulfate infusion prior to anesthesia induction effectively attenuated hemodynamic and arousal response to tracheal intubation comparable to fentanyl in normotensive patients.

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Blood pressure and heart rate changes during intubation: a comparison of direct laryngoscopy and a fibreoptic method

Cited by 28 publications

References 19 publications

Comparison of Hemodynamic Response and Complications in Patients with Difficult Airway Using Two Techniques-Retrograde and Fibreoptic Intubation

Comparison of Hemodynamic Response and Complications in Patients with Difficult Airway Using Two Techniques-Retrograde and Fibreoptic Intubation

Fibreoptic intubation in airway management: a review article

Bispectral index guided attenuation of hemodynamic and arousal response to endotracheal intubation using magnesium sulfate and fentanyl. Randomized, controlled trial

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