Haemodynamic response to laryngoscopy with and without tracheal intubation

Abstract

IntroductionTracheal intubation is accompanied by an increased blood pressure and heart rate. The aim of this study was to find the most important source of this haemodynamic response, namely laryngoscopy or intubation. MethodA standard induction technique was used for all patients. Eighty patients were randomly allocated to one of two groups, one group to undergo laryngoscopy followed by intubation (Group I), and the other laryngoscopy only of duration similar to intubation (Group L). Blood pressure and heart rate were recorded in the ward, before induction of anaesthesia and one, two, three, and four minutes after instrumentation. ResultsThe instrumentation times did not differ significantly (p = 0.20). Over time mean arterial pressures were significantly higher in Group I than in Group L (p = 0.038). Over time the ratios of mean blood pressure and heart rate relative to the preoperative heart rate were significantly greater in Group I than in Group L (p < 0.01). ConclusionBlood pressures and heart rates were significantly greater after laryngoscopy followed by intubation than after laryngoscopy of the same duration not followed by intubation. The induction technique, consisting of lignocaine, alfentanil, and propofol, may have attenuated expected increases in blood pressure but not increases in heart rate after intubation.

Comparison of hemodynamic responses to laryngoscopy and intubation using Macintosh or McCoy or C-MAC laryngoscope during uniform depth of anesthesia monitored by entropy

“…The stress response to laryngoscopy and intubation, is a well-known centrally mediated, sympathetic reflex associated with a cardiovascular response, of elevated blood pressure, heart rate and dysrhythmias, cough reflexes, increased ICP and increased intraocular pressure. [ 6 7 8 ] If no specific measures are taken to prevent hemodynamic response, the HR can increase from 26% to 66% depending on the method of induction and SBP can increase from 36% to 45%. [ 9 10 11 12 13 ]…”

Comparison of C-MAC® Video Laryngoscope and Macintosh Conventional Laryngoscope for Nasotracheal Intubation Convenience in Adult Malay Race Population

“…15 Smith et al also found that mean arterial pressure and heart rate significantly increased in laryngoscopy with intubation group. 16 Research by Marsaban et al gave results that cardiovascular response and the need of Backwards Upwards Rightwards Pressure (BURP) manuever during laryngoscopy was lower in C-MAC® than conventional laryngoscope (19,3% to 40,3%, p=0,014). 17 Ng et al also stated the similar thing compared to McGrath® laryngoscope, 18 and even lower compared to Macintosh device.…”

Comparison of Intubation Quality and Haemodynamic Response in Endotracheal Intubation Between Superior Laringeus and Transtracheal Block and Muscle Relaxants

“…Tindakan laringoskopi intubasi biasa dilakukan untuk menjaga jalan nafas, ventilasi mekanik, dan sebagai fasilitasi pemberian gas anestesi, namun dapat menstimulasi refleks batuk, spasme laring, dan sistem saraf simpatis yang berakibat meningkatnya tekanan darah dan denyut nadi yang dapat berbahaya bagi pasien. [1][2][3] Obat-obatan pelumpuh otot dengan dosis yang besar sering digunakan sebagai fasilitasi untuk memudahkan laringoskopi intubasi. 4,5 Tindakan ini diikuti tindakan reversal dengan obat-obat anticholinesterase untuk mendapatkan kembali nafas spontan pasien, yang apabila inadekuat tidak jarang menyebabkan rekurarisasi atau kelumpuhan otot kembali.…”