Arterial Blood Pressure and Heart Rate Response to Lightwand or Direct Laryngoscopy for Endotracheal Intubation

Abstract

Background: Tracheal intubation commonly results in sympathetic stimulation manifested by increased heart rate and arterial blood pressure. This study was carried out to determine whether lightwand would result in less hemodynamic changes than direct laryngoscopy. Methods: With informed consent, fourty healthy female patients scheduled of elective surgical procedures were randomly allocated into two groups; lightwand(LW) or direct laryngoscopy(DL) group. Mean arterial pressure(MAP) and heart rate(HR) were recorded upon arrival. Under a standardized anesthetic technique, the patients were intubated either with no. 3 curved blade direct laryngoscopy(DL group) or with lightwand(LW group). The MAP and HR were recorded before intubation and every 1 minutes following intubaion. Time to intubation(TTI) was also recorded. All patients were intubated by a same fourth grade resident. Results: Fourty patients were studied. Every intubation was successed in first attempt. The TTI was significantly shorter in LW group. Even while there was no significant difference in HR changes, there was significant difference in the increase of MAP following intubation. The increase of MAP was significantly greater with DL than with LW. Conclusions: This study suggests that lightwand intubation requires shorter TTI and may give rise to less blood pressure change than direct laryngoscopy. So we found no difference in disadvantage and may offers advantage in terms of hemodynamic stability.(Korean J Anesthesiol 1997; 33: 858∼863)