Attenuation of haemodynamic responses to tracheal intubation by the StyletScope

Abstract

Tracheal intubation often causes a haemodynamic response probably generated by direct laryngoscopy. The StyletScope is a new intubation device that does not require direct laryngoscopy. We prospectively measured haemodynamic changes after tracheal intubation using the StyletScope. The increase of heart rate was less during tracheal intubation with the StyletScope when compared with the Macintosh laryngoscope.

Haemodynamic response to endotrachial intubation: direct versus video laryngoscopy

“…Direct laryngoscopy involves stretching the oropharyngeal tissues in an attempt to straighten the angle between the mouth and the glottic opening, and this stretch can cause pain and trigger a stress response. 7 Both laryngoscopy and intubation separately result in sympathetic stimulation, but the catecholamine rise with intubation exceeds that with laryngoscopy alone. 8 Various anaesthetic agents, adjuvants and analgesics have been used to blunt the level of stimulation and the stress response to the manipulation and stimulation of airway during laryngoscopy and intubation.…”

L’assistance vidéoscopique facilite l’intubation endotrachéale des patients pédiatriques

“…2 0 To use optical stylets alone without the use of a laryngoscope may reduce the potential hemodynamic changes and the morbidity associated with direct laryngoscopy. 21,22 However, the presented video-intuboscopic intubation technique is not a primary endoscopic intubation technique but an option to aid conventional tracheal intubation when unexpected difficulties with direct laryngoscopy arise. In addition, the use of the VOIS with conventional laryngoscopy remains a familiar procedure, maintains the airway open, and reduces the risk of contamination of the distal lens by blood or secretions.…”

Haemodynamic Response to Tracheal Intubation: A Comparison of Direct Laryngoscopy, Intubating Laryngeal Mask Airway and Lightwand Guided Intubation Techniques

“…Endotracheal intubation using direct vision laryngoscopy (DLS) is a time tested method and is a rapid, relatively simple, safe and non surgical technique that achieves all the objectives of airway management; namely maintaining airway patency, protecting the lungs from aspiration and permitting leak free mechanical ventilation; thus currently it is the gold standard procedure for airway management but is frequently associated with profound cardiovascular effects including pressor response and tachycardia along with increase in catecholamine levels. [1,2] Despite direct-vision laryngoscopy, accurate and prompt placement of the endotracheal tube remains a considerable challenge in some patients, even in experienced hands which is especially true in "unanticipated" difficult airways or patients requiring emergency tracheal intubation. [3] Intubating Laryngeal Mask Airway (ILMA) was developed by Dr. Archie Brain in 1997, which was intended to provide both ventilation and the consistent ability to pass an endotracheal tube blindly into the trachea, thus making it a suitable alternative to endotracheal intubation using direct laryngoscopy.…”