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Blood pressure and heart rate changes during fibreoptic orotracheal intubation: a comparison of children and adults

Published online by Cambridge University Press:  20 June 2006

F. S. Xue ,
G. H. Zhang ,
H. T. Sun ,
C. W. Li ,
K. P. Liu ,
Y. C. Xu  and
Y. Liu
F. S. Xue
Affiliation:
Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Anaesthesiology, Beijing, People's Republic of China
G. H. Zhang
Affiliation:
Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Anaesthesiology, Beijing, People's Republic of China
H. T. Sun
Affiliation:
Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Anaesthesiology, Beijing, People's Republic of China
C. W. Li
Affiliation:
Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Anaesthesiology, Beijing, People's Republic of China
K. P. Liu
Affiliation:
Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Anaesthesiology, Beijing, People's Republic of China
Y. C. Xu
Affiliation:
Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Anaesthesiology, Beijing, People's Republic of China
Y. Liu
Affiliation:
Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Anaesthesiology, Beijing, People's Republic of China
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Extract

Summary

Background and objectives: Autonomic circulatory regulation and airway anatomy in children are significantly different from those in adults. There is no available published data to compare whether there is a clinically relevant difference in the haemodynamic responses to fibreoptic orotracheal intubation (FOI) under the same conditions between children and adults. In this randomized clinical study, we compared the blood pressure (BP) and heart rate (HR) changes during FOI in 40 children aged 3.5–9 yr and 40 adults aged 21–57 yr, ASA 1 scheduled for elective plastic surgery under general anaesthesia requiring orotracheal intubation. Methods: Anaesthesia was induced with intravenous (i.v.) injection of fentanyl and propofol, and face mask inhalation of isoflurane before FOI. Noninvasive BP and HR were recorded before induction (baseline values), after induction (postinduction values), at intubation and for 5 min after intubation at 1-min intervals. The percentage changes of BP and HR at each time point were calculated. Results: In children and adults, HR at intubation and 1–3 min after intubation were significantly higher than baseline and postinduction values. In adults, BP at intubation increased significantly compared to the postinduction values but did not exceed baseline values. In children, BP at intubation and 1 min after intubation were significantly higher than postinduction and baseline values. As compared to adults, FOI caused a more significant pressor response in children. The percentage changes of BP at intubation and 1 min after intubation were larger in children than in adults. However, there was no significant difference in the percentage change of HR during the observation between children and adults. Conclusions: Under general anaesthesia, FOI might cause a more significant pressor response in children than in adults.

Keywords

INTUBATION, INTRATRACHEAL, fibreoptic bronchoscopeANAESTHESIA GENERALCARDIOVASCULAR PHYSIOLOGYCHILDRENADULTSHAEMODYNAMIC PHENOMENA, blood pressure, heart rate
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 1 , January 2007 , pp. 39 - 45
Copyright
© 2006 European Society of Anaesthesiology

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