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[Fiberoptic intubation and stress]

F Latorre1, M Hofmann, P P Kleemann

  • 1Klinik für Anästhesiologie, Johannes Gutenberg-Universität Mainz.

Der Anaesthesist
|July 1, 1993
PubMed
Summary

Fiberoptic nasotracheal intubation and laryngoscopy with topical anesthesia do not cause major stress responses. Both methods showed lower diastolic blood pressure compared to standard intubation, benefiting patients sensitive to hemodynamic changes.

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Reply by Authors.

The Journal of urology·2022

Area of Science:

  • Anesthesiology
  • Critical Care Medicine

Background:

  • Nasotracheal intubation using fiberoptic endoscopy is a standard technique for managing difficult airways.
  • The impact of avoiding direct laryngoscopy on the stress response during nasotracheal intubation requires further investigation.

Purpose of the Study:

  • To evaluate the hypothesis that fiberoptic nasotracheal intubation reduces the stress response compared to laryngoscopic intubation.
  • To compare hemodynamic and catecholamine stress responses across different nasotracheal intubation techniques.

Main Methods:

  • A prospective, randomized, controlled study involving 30 patients undergoing maxillofacial surgery.
  • Patients were divided into three groups: fiberendoscopic nasotracheal intubation, laryngoscopic intubation with topical laryngeal anesthesia, and laryngoscopic intubation without topical anesthesia.
  • Hemodynamic variables and plasma catecholamine concentrations were measured at multiple time points.

Main Results:

  • No significant hemodynamic or endocrine stress responses were observed in any group.
  • Diastolic blood pressure was significantly lower one minute after intubation in the fiberendoscopic and topical anesthesia groups compared to the control group.
  • Groups were comparable regarding age, body weight, and gender.

Conclusions:

  • Nasotracheal intubation, when performed according to the study protocol, does not induce a significant stress response.
  • Fiberoptic intubation and laryngoscopy with topical laryngeal anesthesia are superior in maintaining lower diastolic arterial pressure.
  • These techniques may be beneficial for patients where increased rate-pressure product is undesirable.

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