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GENERAL ARTICLES

A Comparison of Hemodynamic Changes After Endotracheal Intubation by Using the Lightwand Device and the Laryngoscope in Normotensive and Hypertensive Patients

Department of Anesthesiology, Sapporo Medical University, School of Medicine, Chuo-ku, Sapporo, Japan

Address correspondence and reprint requests to Kohki Nishikawa, MD, Department of Anesthesiology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo, 060-0061, Japan.

We compared the effects of the lightwand technique on hemodynamic responses, time-to-intubation, number of attempts, and complications during tracheal intubation with those of direct-vision laryngoscopy in normotensive (LN and TN group; n = 20, respectively) and hypertensive (LH and TH group; n = 20, respectively) patients. Lightwand or laryngoscopic oral endotracheal intubation was performed after the induction of anesthesia with fentanyl and propofol and muscle relaxation with vecuronium. Systolic blood pressure, diastolic blood pressure, and heart rate were recorded, and the change from "before intubation" to "immediately after intubation" (P) in each variable was calculated. In normotensive patients, significantly larger P in systolic blood pressure was observed in the LN group than in the TN group (P < 0.05). In hypertensive patients, there were no significant differences between the LH group and the TH group in P after intubation. The time-to-intubation and number of attempts in the lightwand groups were significantly longer and more frequent than those in the laryngoscope groups (P < 0.05). The number of patients who complained of hoarseness was larger in the lightwand groups than in the laryngoscope groups (P < 0.05). We conclude that the lightwand technique significantly attenuates hemodynamic changes after intubation in comparison with the laryngoscopic technique in normotensive patients. However, in hypertensive patients, there is no difference in hemodynamic changes between the two techniques.

Implications: A lightwand technique was accompanied by less hemodynamic changes after tracheal intubation than the laryngoscopic technique in normotensive patients. In hypertensive patients, however, no difference was found between the two techniques.

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