This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nishikawa, K. Articles by Namiki, A. Search for Related Content PubMed PubMed Citation Articles by Nishikawa, K. Articles by Namiki, A.

Lightwand intubation is associated with less hemodynamic changes than fibreoptic intubation in normotensive, but not in hypertensive patients over the age of 60

[L'intubation avec stylet lumineux, comparé au fibroscope, entraîne moins de changements hémodynamiques chez les patients normotendus, non chez les hypertendus, de plus de 60 ans]

From the Department of Anesthesiology, Sapporo Medical University, School of Medicine, Sapporo, Japan.

Dr. Kohki Nishikawa, Department of Anesthesia, Otaru Hokusei Hospital, 8-18 Umegae-cho, Otaru, Hokkaido 047-0044, Japan. Phone: +81-134-25-4321; Fax: +81-134-25-2888; E-mail: hokuseiope{at}mac.com

Purpose: To compare the effects of the lightwand and fibreoptic techniques for intubation, neither of which require laryngoscopy, on hemodynamic responses associated with tracheal intubation in normotensive and hypertensive elderly patients.

Methods: Eighty-eight normotensive and hypertensive patients aged more than 60 yr were randomly allocated to either the lightwand (LN and LH group, n=22 in both) or the fibreoptic group (FN and FH group, n=22 in both). All intubations were performed after induction of anesthesia with fentanyl and propofol and muscle relaxation with vecuronium. Systolic and mean arterial pressures (SAP and MAP) and heart rate (HR) were recorded, and rate-pressure product (RPP) and the change from "before intubation" to "immediately after intubation" of each variable (MAP ,HR and RPP) were calculated.

Results: In normotensive patients, significantly smaller MAP, HR and RPP were observed in the LN group than in the FN group (P <0.05). In hypertensive patients, no significant differences between the LH group and the FH group were found in MAP or HR, while values of mean RPP in both groups were less than 20,000.

Conclusion: We conclude that the lightwand technique significantly attenuates hemodynamic changes following intubation in comparison with fibreoptic intubation in normotensive patients over the age of 60. Hemodynamic changes following intubation using the lightwand technique and the fibreoptic technique in hypertensive elderly patients are similar. However, both techniques are useful for intubation in hypertensive elderly patients in terms of RPP.