The Effect of Advancing Age on the Sympathetic Response to Laryngoscopy and Tracheal Intubation

Bullington, J.; Perry, S. M.; Rigby, J.; Pinkerton, Mark; Rogers, Derek J.; Lewis, Thomas C.; Preganz, P.; Wood, Alastair J.J.; Wood, Margaret

doi:10.1213/00000539-198905000-00010

Cited by 26 publications

(9 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are several important differences between Bullington's study 8 and ours. Firstly, their study patients received intramuscular atropine 0.4 mg sixty minutes before induction.…”

Section: Discussioncontrasting

confidence: 68%

“…Studies in exercise physiology show that ageing reduces the maximal heart rate and ejection fraction 7 . This has been explained on the basis of age-related decrease in target organ responsiveness despite serum catecholamine levels exceeding those seen in younger patients 8 . This can be due to a reduced number of receptors, reduced receptor activity or declining maximal end organ function.…”

Section: Discussionmentioning

confidence: 99%

“…The catecholamine and haemodynamic response related to tracheal intubation in relation to age was initially studied by Bullington and colleagues in 1989 8 . They found a lesser chronotropic response in the elderly but no difference in the blood pressure response between the middle-aged and elderly P Pe er rc ce en nt ta ag ge e c ch ha an ng ge e f fr ro om m b ba as se el li in ne e M Mi in nu ut te es s a af ft te er r e en nd do ot tr ra ac ch he ea al l i in nt tu ub ba at ti io on n M Mi in nu ut te es s a af ft te er r i in nd du uc ct ti io on n 1 1 m mi in n a af ft te er r a an na al lg ge es si ia a patients 8 . The findings in our study confirm the decreased chronotropic response in the elderly group but there were important differences observed in the blood pressure response between the age groups.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of Age on Haemodynamic Response to Tracheal Intubation. A Comparison of Young, Middle-aged and Elderly Patients

Ismail

2002

Anaesth Intensive Care

View full text Add to dashboard Cite

The effect of age on the haemodynamic response to tracheal intubation was studied. Ninety ASA 1 or 2 patients were divided into three groups of 30 each based on age; i.e., young (18-25 years), middle-aged (40-50 years) and elderly (65-80 years). The haemodynamic response after tracheal intubation was observed as percentage change in heart rate and blood pressure compared to the baseline. Inter-group comparison was also done at different time points. The greatest percentage change in the systolic arterial pressure after tracheal tube insertion was seen in the elderly group (15%). The increase in systolic arterial pressure was significantly less in the young group compared with the two older groups at one, two, three and four minutes post-intubation. The greatest percentage increase in the diastolic blood pressure compared to the baseline was seen in the middle aged group (24%). The elderly and young patients showed a significant difference in the diastolic blood pressure response only at one minute post-intubation. The heart rate response was greatest in the middle-aged patients (40%) and least in the elderly (16%). These differences may have clinical significance and should be considered in assessing and performing research into the haemodynamic response to intubation.

show abstract

“…There are several important differences between Bullington's study 8 and ours. Firstly, their study patients received intramuscular atropine 0.4 mg sixty minutes before induction.…”

Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Age on Haemodynamic Response to Tracheal Intubation. A Comparison of Young, Middle-aged and Elderly Patients

Ismail

2002

Anaesth Intensive Care

View full text Add to dashboard Cite

show abstract

“…Laryngoscopy and tracheal intubation are known to cause sympathy -adrenal stimulation. This manifests as hypertension and tachycardia ( 6 , 7 ). These transient changes have no deleterious consequences in healthy individual, but in some patients they can provoke left ventricular failure, myocardial ischemia and cerebral hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Responses to Tracheal Intubation in Elderly Patients: Intravenous or Spray of Lidocaine versus Fentanyl

et al. 2017

View full text Add to dashboard Cite

IntroductionLaryngoscopy and tracheal intubation are known to increase sympathetic activity that may be detrimental to patients with preexisting ischaemic or hypertensive heart disease.AimThe aim of this study was to compare of intravenous and oropharyngeal spray of lidocaine and high dose of fentanyl on systolic and diastolic blood pressures and heart rate of patients over 65 years during tracheal intubation.Material and MethodsIn this clinical trial, 160 patients over 65 yrs who were randomly divided into five groups of 32 patients. For group one lidocaine spray 10%, group two intravenous lidocaine 1.5 mg/kg, group three lidocaine spray along with intravenous lidocaine 0.75 mg/kg, and for group four fentanyl 5μg/kg were administered and group five patients were controls which were given 1 mg of midazolam along with 2 μg/kg fentanyl. Systolic and diastolic blood pressures and heart rate were measured before and after anesthesia and intubation. ANOVA, Scheffe’s and Repeated measure tests were used for data comparison and P<0.05 was considered significant.ResultsNo significant difference was detected in terms of gender among the understudy groups. The mean (SD) age of patients in all groups were 69 ±3.5 yrs. (65-80 yrs.) and there is no significant difference was detected between the mean age and other basic variables of under study groups (P<0.328). Study results showed that the kind of surgery hasn’t different between groups. The table showed that no difference between male and female. No significant difference was observed between groups with different sizes of tracheal tube in terms of systolic and diastolic blood pressures and heart rate. No significant difference was detected in terms of systolic and diastolic blood pressures and heart rate among groups prior to the induction of anesthesia.ConclusionAll methods were effective for efficient blood pressure control during laryngoscopy and tracheal intubation.

show abstract

“…3 Laryngoscopy is also associated with increases in intercranial pressure. 4 Aspiration, bleeding, airway obstruction, pneumonia, and dental injury are other potential complications. For these reasons, the fewest tracheal intubation attempts would pose the least physiologic insult to a patient.…”

Section: Purposementioning

confidence: 99%

Attempts at Emergent Tracheal Intubation of Inpatients: A Retrospective Practice Analysis Comparing Adjunct Sedation With or Without Neuromuscular Blockade

Atlas¹,

Mort²

2003

IJA

View full text Add to dashboard Cite

As part of emergency airway management, anesthesia personnel are frequently responsible for the emergent tracheal intubation of inpatients. The purpose of this retrospective analysis was to examine the number of attempts necessary for a successful emergent inpatient tracheal intubation. All intubation attempts had utilized adjunct sedation. Patient age, gender, and the use of neuromuscular blockade (NMB) were also investigated. Overall, 73.1% of all intubations, were reported as successful, having used only adjunct sedation and without the use of NMB (P<0.001). This was regardless of the number of attempts reported for each intubation. Furthermore, 54.9% of all intubations had been reported as successful, on the first attempt, without NMB (P<0.001). An association, between tracheal intubation attempts and the use of NMB, had also been retrospectively observed. NMB, when used, was found to have been associated with a greater number of intubation attempts (P<0.0001). NMB was also noted to have been used more often with younger inpatients (P<0.001) and males (P<0.01). The probability, of a successful emergent inpatient tracheal intubation attempt, was found to have been associated with only NMB use (P<0.001). This was accomplished using a logistic regression model. Using this model, neither age nor gender were determined to have been factors for multiple intubation attempts. Based on this retrospective analysis, it appears that NMB does not need to be used, on a routine basis, for emergent inpatient tracheal intubations.

show abstract

The Effect of Advancing Age on the Sympathetic Response to Laryngoscopy and Tracheal Intubation

Abstract: WOOD AJJ, WOOD M. The effect of advancing age on the sympathetic response to laryngoscopy and tracheal intubation. Anesth Analg 1989;68:603-8.

Cited by 26 publications

References 6 publications

Effect of Age on Haemodynamic Response to Tracheal Intubation. A Comparison of Young, Middle-aged and Elderly Patients

Effect of Age on Haemodynamic Response to Tracheal Intubation. A Comparison of Young, Middle-aged and Elderly Patients

Hemodynamic Responses to Tracheal Intubation in Elderly Patients: Intravenous or Spray of Lidocaine versus Fentanyl

Attempts at Emergent Tracheal Intubation of Inpatients: A Retrospective Practice Analysis Comparing Adjunct Sedation With or Without Neuromuscular Blockade

Contact Info

Product

Resources

About