Anesth Analg 2007;105:543
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000265692.75284.69
LETTER TO THE EDITOR
Section Editor:
Lawrence Saidman
Is the Hemodynamic Response to Nasotracheal Fiberoptic Bronchoscopy Less Than That Following Orotracheal Bronchoscopy?
Yushi U. Adachi, MD, PhD,
Katsumi Suzuki, MD,
Yukako Obata, MD,
Matsuyuki Doi, MD, PhD, and
Shigehito Sato, MD, PhD
Intensive Care Unit of University Hospital; Hamamatsu University School of Medicine; Hamamatsu, Japan; yuadachi{at}hama-med.ac.jp
To the Editor:
Xue et al. (1–5) have comprehensively investigated the effect of intubation on hemodynamic responses and recently demonstrated that circulatory responses to fiberoptic nasotracheal intubation are fewer and of a shorter duration than those following fiberoptic orotracheal intubation in anesthetized children (6).
In all of these studies, tracheal intubation followed induction of anesthesia using IV hypnotics and inhalation of volatile anesthetics without attention to maintaining a constant and equal alveolar anesthetic concentration. Because the hemodynamic response to tracheal intubation (independent of the method of intubation) depends to some extent upon depth of anesthesia, the results from all of these studies (1–6) are difficult to interpret. In other words, if hemodynamic responses to different intubation techniques are compared, the anesthetic depth, including the alveolar concentration of anesthetic should be equivalent at the time of intubation. In the absence of these standard conditions, the results are both not generalizable and uninterpretable.
REFERENCES
- Xue FS, Zhang GH, Sun HT, Li CW, Liu KP, Xu C, Liu Y. Blood pressure and heart rate changes during intubation: a comparison of direct laryngoscopy and a fibreoptic method. Anaesthesia 2006;61:444–8[Web of Science][Medline]
- Xue FS, Li CW, Sun HT, Liu KP, Zhang GH, Xu YC, Liu Y, Yu L. The circulatory responses to fibreoptic intubation: a comparison of oral and nasal routes. Anaesthesia 2006;61:639–45[Web of Science][Medline]
- Xue FS, Liao X, Liu KP, Xu YC, Yang QY, Li P, Li CW, Sun HT. The circulatory responses to tracheal intubation in children: a comparison of the oral and nasal routes. Anaesthesia 2007;62:220–6[Web of Science][Medline]
- Xue FS, Zhang GH, Sun HT, Li CW, Li P, Liu KP, Xu YC, Liu Y, Liu J. A comparative study of hemodynamic responses to orotracheal intubation with fiberoptic bronchoscope and laryngoscope in children. Pediatr Anaesth 2006;16:743–7[Medline]
- Xue FS, Zhang GH, Sun HT, Li CW, Liu KP, Xu YC, Liu Y. Blood pressure and heart rate changes during fibreoptic orotracheal intubation: a comparison of children and adults. Eur J Anaesthesiol 2007;24:39–45[Web of Science][Medline]
- Xue FS, Li CW, Liu KP, Sun HT, Zhang GH, Xu YC, Liu Y. Circulatory responses to fibreoptic intubation in anesthetized children: a comparison of oral and nasal routes. Anesth Analg 2007;104:283–8[Abstract/Free Full Text]
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F. S. Xue, C. Wen Li, K. P. Liu, H. Tao Sun, G. H. Zhang, Y. Chao Xu, and Y. Liu
Is the Hemodynamic Response to Nasotracheal Fiberoptic Bronchoscopy Less Than That Following Orotracheal Bronchoscopy?
Anesth. Analg.,
August 1, 2007;
105(2):
543 - 544.
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