Hemodynamic Changes after Endotracheal Iintubation with a Lightwand or a Laryngoscope in Patients with Cerebral Aneurysm

Laryngoscopy and tracheal intubation induce the patients airway reflexes and lead to hypertension and tachycardia. The changes during intubation may cause a rupture of cerebral aneurysm and increase the risk of subarachnoid hemorrhage. It is reported that tracheal intubation with lightwand results in less hemodynamic stimulation compared with direct laryngoscopy. We therefore conducted this study to assess that the lightwand technique could result less hemodynamic changes during intubation. Twenty six patients undergoing cerebral aneurysm clipping surgery were included. On arrival to the operating room, patients were monitored with direct arterial pressure, electrocardiogram, pulse oximetry and BIS. All patients received fentany(1-2 ㎍/kg), dormicum(0.05-0.1 mg/kg) and thiopental sodium(3-4 mg/kg) followed by vecuronium(0.1-0.15 mg/kg). The lungs were ventilated with 3% isoflurane in oxygen. 1% lidocaine(1 mg/kg) were administered 90 seconds before the intubation. Patients were then intubated with either the lightwand or the laryngoscope when end expiratory isoflurane concentration 2 vol% and BIS less than 40. Room light were dimmed and the endotracheal tube was introduced into the oral cavity and advanced until midline illumination was observed in the anterior neck. Systolic and diastolic blood pressures and heart rate were recorded continuously before and after intubation for 5 minutes. There were no differences in sex, age, weight, initial blood pressure and initial heart rate between the two groups. And there were no differences in hemodynamic changes after intubation between the two goups. We found that, in patients with cerebral aneurysm, a lightwand intubation technique does not reduce the hemodynamic responses when compared to a laryngoscopy. Pharmacologic manipulation and volatile anesthetics might control the changes in blood pressure and heart rate associated with tracheal intubation.

Author dc:creator

• 윤, 채리

Contributors dc:contributor

• 문, 봉기
• 대학원 의학과
• 200324280

• 뇌동맥류환자
• 기관삽관
• 광봉
• 직접후두경

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000000768
000000000768

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/2322