Stress response to tracheal intubation: direct laryngoscopy compared with blind oral intubation

Abstract

Summary Haemodynamic and hormonal responses to tracheal intubation can be profound and associated with

Effects of propofol on intraoperative parathyroid hormone monitoring in patients with primary hyperparathyroidism undergoing parathyroidectomy: a randomized control trial

“…8 Mean PTH concentrations in our patients increased in response to anesthetic induction ( Table 2). The catecholamine surge that occurs in response to tracheal intubation 9,10 has been shown to stimulate the PTH secretion. 11 Mahajna et al 11 reported a large increase in serum PTH in patients with normal parathyroid function; however, only female patients with primary HPT experienced a modest albeit statistically significant increase in serum PTH, while this increase was not significant in patients with secondary HPT.…”

Attenuation of Hemodynamic Response to Direct Laryngoscopy and Intubation Using 10% Lignocaine Spray : A Clinical Study

“…Pernestorfer et al (16) in 1995 compared direct laryngoscopy intubation and blind oral intubation found increase in B.P and noradrenalin is significantly increase in direct laryngoscopy and intubation than blind oral even though blind oral intubation taken longer duration to achieve possible explanation being the force applied by direct laryngoscopy.…”

“…Although this hemodynamic response is due to sympathetic adrenergic reflex to laryngoscopy and intubation, most of the studies or the approach using different agents are aimed at blocking the effect of the reflex rather than preventing the stimulation starting from inducing agents thiopentone, propfol (6) analgesics, (7) different opioids, (8)(9) beta blockers, (10)(11) calcium channel blockers, (12)(13) sodium channel blocker (14) and of late alpha2 agonists. (15) Some attempts made to reduce the stimulation include different techniques of intubation, Blaind oral intubation, (16) fiber optic intubation. (17) Few attempts by anaesthetizing the posterior part of tongue and valecula are also made by nerve block(glossopharyngial, laryngeal and transtracheal nerve) (18)(19) Lignocaine 2% viscus gargling, (20) topical spray 4% (21) and 10% (22) most of the methods used to attenuate the presser responses are effective.…”

Parathyroid Hormone Response to Tracheal Intubation in Hyperparathyroid Patients and Normal Subjects

“…THE physiologic response to tracheal intubation was investigated many years ago and we are now aware of rapid changes in blood levels of adrenalin, noradrenalin, cortisol, adrenocorticotropic hormone, aldosterone and thyroid hormone following this procedure [1][2][3][4]. These responses were attributed to the stress of direct laryngoscopy and passing the tube through the vocal cords [5][6][7]. Catecholamines are known stimulants of parathyroid hormone (PTH) secretion [8][9][10].…”

“…These responses were attributed to the stress of direct laryngoscopy and passing the tube through the vocal cords [5][6][7].…”