Cardiovascular Responses to Tracheal Intubation: A Comparison of Direct Laryngoscopy and Fibreoptic Intubation

Abstract

The cardiovascular responses to tracheal intubation using a jibreoptic bronchoscope or Macintosh laryngoscope were compared in twenty in-patients and twenty day-stay patients. Within these groups patients were randomly allocated to direct laryngoscopic or jibreoptic bronchoscopic intubation. Arterial blood pressure, heart rate and arterial oxygen saturation were recorded before induction and at one-minute intervals untilfour minutes after intubation. In both groups both laryngoscopic and bronchoscopic intubation resulted in a significant rise in blood pressure and heart rate. At no stage was there a significant difference in mean blood pressure in either group, or in heart rate in the day-stay patients, betl'v'een the different methods of intubation. In the in-patients mean heart rate was signijicantly higher in those patients intubated with the bronchoscope at three and four minutes after intubation. Time taken for intubation was significantly longer in those patients intubated with the bronchoscope. In no patient did the arterial oxygen saturation fall below 98%.

Blood pressure and heart rate changes during intubation: a comparison of direct laryngoscopy and a fibreoptic method

“…Although fibreoptic intubation can avoid direct stimulus to the base of tongue and epiglottis which may be exerted by direct laryngoscopy, our results show that the circulatory responses to nasotracheal intubation are significantly greater in the fibreoptic bronchoscope group than in the direct laryngoscopy group. Our results correspond with those of some other comparative studies [5, 6].…”

The circulatory responses to fibreoptic intubation: a comparison of oral and nasal routes

“…This study has clearly showed that under general anaesthesia in female adults, both FOI and FNI cause significant increases in blood pressure and heart rate. Our results correspond with those of previous studies in general anaesthetised adult patients [1, 2, 4–6, 8–10, 13].…”

“…The increasing use of fibreoptic bronchoscopy in clinical anaesthesia has drawn attention to the circulatory responses during fibreoptic intubation. Many relevant studies have been carried out in this field [1–13], but despite the tremendous differences in the airway stimuli caused by nasal and oral intubations, only one small study [14] has compared the circulatory responses to fibreoptic orotracheal intubation (FOI) and fibreoptic nasotracheal intubation (FNI) under a combination of neuroleptic analgesia and topical anaesthesia. The present randomised clinical study was designed therefore to investigate in a larger sample whether there is a clinically relevant difference between the circulatory responses to FOI and FNI when carried out by experienced practitioners in healthy, female patients receiving general anaesthesia.…”

A comparative study of hemodynamic responses to orotracheal intubation with fiberoptic bronchoscope and laryngoscope in children

“…Although the FOB can avoid the direct stimulus to the base of tongue and epiglottis exerted by direct laryngoscopy, the pres-sor and tachycardiac responses to orotracheal intubations using a FOB and a DLS in our study were not significantly different. Our results correspond with those of other studies in adults (1)(2)(3)(4) and infants aged <2 years (5).…”