Hemodynamic Changes after Endotracheal Intubation in Patients with Cerebral Aneurysm.
- Author:
Cherry YOON
1
;
Kwan Sik PARK
;
Sung Yong PARK
;
Yun Jeong CHAE
;
Sang Kee MIN
;
Sook Young LEE
;
Hyung Ju PARK
;
Hyun Ju NO
;
Bong Ki MOON
Author Information
1. Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea. mbk@ajou.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
cerebral aneurysm;
laryngoscope;
lightwand;
tracheal intubation
- MeSH:
Aneurysm;
Arterial Pressure;
Fentanyl;
Heart Rate;
Hemodynamics;
Humans;
Intracranial Aneurysm;
Intubation;
Intubation, Intratracheal;
Isoflurane;
Laryngoscopes;
Lidocaine;
Lung;
Midazolam;
Oxygen;
Thiopental;
Vecuronium Bromide
- From:Anesthesia and Pain Medicine
2008;3(1):49-54
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Tracheal intubation with a lightwand intubating device (Trachlight) attenuates the hemodynamic stress response to tracheal intubation compared with a direct laryngoscope approach. We compared the effects of the direct laryngoscope (Macintosh blade) and lightwand for intubation in patients with cerebral aneurysm. METHODS: Twenty-four patients undergoing cerebral aneurysm clipping surgery were randomly divided to either the lightwand (Group 1, n = 12) or the laryngoscope (Group 2, n = 12) Group. All patients received fentanyl (2-3microg/kg), midazolam (0.1 mg/kg), and thiopental sodium (2-3microg/kg) followed by vecuronium (0.1- 0.15microg/kg). The lungs were ventilated with 3-4% isoflurane in oxygen, with 1% lidocaine (1-1.5microg/kg) administered before intubation with either the lightwand or the laryngoscope. Systolic, diastolic and mean blood pressures and heart rate were recorded continuously before and for 5 min after intubation. RESULTS: Systolic and mean arterial blood pressure increased significantly (P < 0.05) 1 minute after intubation, but then returned to normal within the next minute. There were no differences in hemodynamic changes between the two groups, and no complications. CONCLUSIONS: Intubation technique did not affect hemodynamic changes in patients with cerebral aneurysm. In patients with aneurysms, appropriate anesthetic levels and pharmacologic manipulation will attenuate the hemodynamic stress response associated with tracheal intubation.
