Comparative Study of Hemodynamic Changes and Complications following Lightwand of Laryngoscopic Intubation

Yum, Kwang Won; Oh, Yong Seok; Oh, Seung Eun

doi:10.4097/kjae.1995.28.2.203

Cited by 3 publications

(2 citation statements)

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“…Transillumination is an alternative method to direct laryngoscopic intubation for difficult intubations. However, the transillumination method also causes hemodynamic changes due to stimuli sympathetic tone when performing tracheal intubation [ 3 ]. We measured EC 50 of effect-site concentration of remifentanil to blunt the hemodynamic change of tracheal intubation with Surch-Lite® during anesthesia with propofol and remifentanil.…”

Section: Discussionmentioning

confidence: 99%

“…Theoretically, use of the transillumination method for tracheal intubation may cause less adrenergic stimulation, because stimulation to epiglottis by laryngoscope is not required. However, many studies show that intubation with the transillumination method also increases blood pressure similar to direct laryngoscope [ 2 , 3 ]. Therefore, intubation with the transillumination method requires drugs for preventing hemodynamic changes due to sympathetic stimulation.…”

Section: Introductionmentioning

confidence: 99%

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Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia

Yon

Kwon

et al. 2011

Korean J Anesthesiol

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BackgroundTransillumination using a light wand is an alternative type of laryngoscope used for tracheal intubation. There is little information available on the effect-site concentration of remifentanil required to control hemodynamic changes induced by tracheal intubation using the transillumination method during total IV anesthesia. We therefore conducted this study to determine the effect-site concentration of remifentanil blunting hemodynamic responses after tracheal intubation in patients receiving propofol anesthesia.MethodsWe enrolled 26 healthy adult patients (ASA physical status I-II), aged 16-67 scheduled for surgery within 2 hours. All patients received a target-controlled infusion of 4 µg/ml propofol. The effect-site target-concentration of remifentanil of 5.0 ng/ml was chosen for the first patient. We used the Dixon's up-and-down sequential allocation method for determining the next remifentanil concentration. The time required for tracheal intubation was measured as the level of intubation stimulation.ResultsThe average intubation time was 13.9 ± 9.1 seconds. From the Dixon's method, the EC50 of remifentanil blunting the hemodynamic response to tracheal intubation was 2.94 ng/ml.ConclusionsThis study shows that effect-site concentrations of remifentanil of 2.94 ng/ml is effective in blunting sympathetic responses to tracheal intubation in 50% of patients with normal airway anatomy when combined with a target controlled infusion of propofol (4 µg/ml).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia

Yon

Kwon

et al. 2011

Korean J Anesthesiol

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What is an Optimal Effect Site Concentration of Remifentanil for Minimizing the Hemodynamic Change to Endotracheal Intubation using Light Wand?

Lee

Jeon

Shim

et al. 2007

Korean J Anesthesiol

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Background:In the previous studies, remifentanil reduces the hemodynamic change induced by endotracheal intubation. We studied the optimal effect site concentration of remifentanil for endotracheal intubation using light wand.Methods: Sixty ASA 1 or 2 patients scheduled for elective surgery under general anesthesia were classified in three groups according to the TCI (target controlled infusion) dose of remifentanil. Each group was administered 4μg/ml of propofol TCI, rocuronium, with 2 ng/ml (group 1), 4 ng/ml (group 2), 6 ng/ml (group 3) of remifentanil TCI. Blood pressure, heart rate and bispectral index score were measured before induction, 3 minutes after remifentanil and propofol TCI, after endotracheal intubation using light wand, and 3 minutes after endotracheal intubation. Statistical analysis was done for comparison of time and dose dependant change among the groups.Results: After endotrachal intubation, blood pressure and heart rate were significantly increased in group 1, and decreased in group 2 and 3. 3 minute after endotracheal intubation, heart rate significantly decreased in group 3, but there were no changes in group 2.Conclusions: The spontaneous BRS was decreased during ketamine induction of general anesthesia. These results suggest that anesthesia induction with ketamine impairs baroreflex control of heart rate, which may provoke hemodynamic instability.

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The Correlation between Blood Pressure Elevation and Intubation Time during Tracheal Intubation using Lightwand or Direct Laryngoscope

Yoo

Lee

et al. 2007

Korean J Anesthesiol

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Comparative Study of Hemodynamic Changes and Complications following Lightwand of Laryngoscopic Intubation

Cited by 3 publications

References 0 publications

Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia

Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia

What is an Optimal Effect Site Concentration of Remifentanil for Minimizing the Hemodynamic Change to Endotracheal Intubation using Light Wand?

The Correlation between Blood Pressure Elevation and Intubation Time during Tracheal Intubation using Lightwand or Direct Laryngoscope

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