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Use of the fibreoptic stylet scope (Styletscope^TM) reduces the hemodynamic response to intubation in normotensive and hypertensive patients

[L'utilisation d'un stylet fibroscopique (Styletscope^TM) réduit la réponse hémodynamique à l'intubation chez les patients normotendus et hypertendus]

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

Address correspondence to: Dr. Michiaki Yamakage, Department of Anesthesiology Sapporo Medical University School of Medicine South 1, West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan. Phone: 81-11-611-2111, ext. 3568; Fax: 81-11-631-9683; E-mail: yamakage{at}sapmed.ac.jp

Purpose: To compare hemodynamic changes after tracheal intubation when using a new fibreoptic stylet scope (Styletscope^TM) and a conventional laryngoscope in normotensive and hypertensive patients.

Methods: Normotensive (N; n=30) and hypertensive (H; n=30) patients undergoing general anesthesia participated in this study. Each group was divided into two groups. In one group, patients were intubated by using a stylet scope with a laryngoscope as an adjuvant (S; n=15 each), while patients in the other group were intubated using a laryngoscope by the usual technique (L; n=15 each). The time necessary for intubation, hemodynamic changes, and adverse effects were recorded.

Results: Patients in the normotensive groups (SN and LN groups) showed significant increases in both systolic and diastolic blood pressures from before induction to one minute after intubation; however, blood pressures in the SN group were significantly lower than those in the LN group. Both systolic and diastolic blood pressures increased after intubation in the LH group, but not in the SH group. Heart rates in all four groups showed significant increases, and there were no differences between heart rates in the stylet scope and laryngoscope groups or between the normotensive and hypertensive groups. The number of patients who complained of sore throat was greater in the laryngoscope groups.

Conclusions: Tracheal intubation with a stylet scope can attenuate hemodynamic changes and reduce the incidence of sore throat in comparison with the conventional laryngoscope technique in both normotensive and hypertensive patients.

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