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Hemodynamic Changes after Endotracheal Intubation in Patients with Cerebral Aneurysm
Anesthesia and Pain Medicine ; : 49-54, 2008.
Article in Korean | WPRIM | ID: wpr-98895
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.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Oxygen / Thiopental / Midazolam / Vecuronium Bromide / Intracranial Aneurysm / Fentanyl / Laryngoscopes / Arterial Pressure / Heart Rate / Hemodynamics Limits: Humans Language: Korean Journal: Anesthesia and Pain Medicine Year: 2008 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Oxygen / Thiopental / Midazolam / Vecuronium Bromide / Intracranial Aneurysm / Fentanyl / Laryngoscopes / Arterial Pressure / Heart Rate / Hemodynamics Limits: Humans Language: Korean Journal: Anesthesia and Pain Medicine Year: 2008 Type: Article