مقايسه تغييرات هموديناميك ناشي از لوله گذاري تراشه با لارنگوسكوپي مستقيم و روش برونكوسكوپي فيبراپتيك در بيماران مبتلاء به پرفشاري خون

Comparison of the hemodynamic changes following tracheal intubation with direct laryngoscopy and fiberoptic bronchoscopy method in hypertensive patients

Background; Laryngoscopy and tracheal intubation have often been associated with a rise in blood pressure and heart rate. One of the proposed methods for reducing these changes is to use a fiberoptic bronchoscope for tracheal intubation. In the present study hemodynamic changes after fiberoptic intubation has been compared with laryngoscopy method in hypertensive patients. Materials and methods: 94 hypertensive patients who had not received antihypertensive medication for at least 10 days were randomly allocated in two groups and anesthetized in the same manner. Intubation in one group was performed with fiberoptic bronchoscope and in the other group by laryngoscope. Hemodynamic parameters including heart rate, systolic and diastolic blood pressure were recorded before induction (baseline), before intubation and 2, 4 and 6 minutes after intubation. Results; Heart rate at 2 minutes and diastolic blood pressure at 4 minutes after intubation in the fiberoptic group and systolic blood pressure at 6 minutes after intubation in the laryngoscopy group were significantly higher than the other group. Comparison of the data obtained after intubation with preintubation values revealed a significant rise except for diastolic blood pressure and heart rate at 6 minutes in the fiberoptic group. Conclusion; The findings of this study reveal that the hemodynamic changes at the early moments of intubation is more prominent with fiberoptic method while its duration is shorter than after laryngoscopy intubation. It seems that the fiberoptic bronchoscopy can not be of much help in the attenuation of hemodynamic reflexes to intubation in hypertensive patients.