Complications Related to the Pressor Response to Endotracheal Intubation

A comparison of the stress response to laryngoscopy

“…Changes in arterial blood pressure and plasma noradrenaline and adrenaline have been shown to be similar, whether or not laryngoscopy is followed by tracheal intubation [7]. These changes may be associated with detrimental physiological effects particularly in those with cardiovascular or cerebrovascular disease [25]. In the present study the increase in heart rate during laryngoscopy with the Macintosh blade of 23% (23 beat.min-I) is similar to that described in previous studies with this blade [2,7,21].…”

Effect of Oral Pregabalin on Hemodynamic Stress Response to Laryngoscopy and Endotracheal intubation

“…Gupta et al also conclude that 150mg of pregabalin attenuates the effect of laryngoscopy and intubation on HR. 20 Bhawna et al however did not observe any advantage for pregabalin regarding HR.…”

“…16 In a comparative study on the effect of oral premedication with 150 mg of pregabalin or 200µg of clonidine, the former provided better sedation. 20 Better sedation reduces psychic stress and this leads to reduction in impulse traffic from the trachea which might help to reduce the severity of hemodynamic response to intubation. Premedication with pregabalin in our study was found to be effective in preventing the adverse hemodynamic responses to laryngoscopy and intubation.…”

Preoperative beta-blockade for patients undergoing craniotomy: a comparison between propranolol and atenolol

“…Burney and Winn 4 demonstrated an increase in intracranial pressure in response to laryngoscopy and tracheal intubation in 14 patients undergoing craniotomy or carotid angiography using a similar induction sequence to that used in this study. Fox et al 2 have reported a case in which laryngoscopy and tracheal intubation in a treated hypertensive patient were followed by fatal rupture of a cerebral aneurysm. The tachycardia associated with tracheal intubation may lower the cerebral perfusion pressure by decreasing the mean arterial pressure and cardiac output, and furthermore may cause excessive haemorrhage if an aneurysm is ruptured.…”