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Evaluation of the cardiovascular responses to fiberoptic orotracheal intubation with television monitoring: comparison with conventional direct laryngoscopy.

Abstract：

STUDY OBJECTIVE:To evaluate and compare cardiovascular responses to a new method of orotracheal intubation incorporating TV monitoring, with conventional orotracheal intubation via rigid blade laryngoscopy. DESIGN:Prospective single-blind study. SETTING:Operating room of a medical college hospital. PATIENTS:90 ASA physical status I and II surgical patients requiring general anesthesia and orotracheal intubation. INTERVENTIONS:Patients were randomly allocated to two groups, one for the new intubation method and the other for conventional intubation using a rigid laryngoscope. In the new method, an anesthesiologist inserted an endotracheal tube alone into the trachea via TV monitoring through the bronchoscope, which was inserted by an assistant through the mouth to the middle larynx. The patient's trachea was intubated without extreme stretching of laryngeal tissues or deep insertion of the tip of the bronchoscope. In the conventional method, orotracheal intubation was performed with rigid direct laryngoscopy. MEASUREMENTS:Noninvasive blood pressure (BP) and heart rate (HR) were measured before arrival at the operating room, and before and after orotracheal intubation. MAIN RESULTS:Although this method was expected to be a minimally invasive fiberoptic intubation technique, the patients showed significant increases in BP and HR. No significant differences between the two groups were observed in cardiovascular responses immediately after intubation: the systolic BP, 169.5 +/- 28.3 versus 167.0 +/- 23.1 mmHg, and HR, 100.2 +/- 18.2 versus 98.8 +/- 16.6 bpm. CONCLUSIONS:Insertion of an endotracheal tube may itself be the most invasive stimulus during intubation procedures.

journal_name

J Clin Anesth

journal_title

Journal of clinical anesthesia

authors

Adachi YU,Takamatsu I,Watanabe K,Uchihashi Y,Higuchi H,Satoh T

doi

10.1016/s0952-8180(00)00196-3

subject

Has Abstract

pub_date

2000-11-01 00:00:00

pages

503-8

issue

7

eissn

0952-8180

issn

1873-4529

pii

S0952-8180(00)00196-3

journal_volume

12

pub_type

临床试验,杂志文章,随机对照试验

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