Salgado Filho Marcello Fonseca, Cordeiro Victor Hugo, Mota Suzana, Prota Marina, Lopez Marina Natalino, de Lara Renzo A
Universidade Federal de Juiz de Fora, Brazil.
Rev Bras Anestesiol. 2011 Jul-Aug;61(4):447-55. doi: 10.1016/S0034-7094(11)70052-6.
Anesthesiologists are responsible for airway management whenever they assume the anesthesia of a patient. In this study, we compare the hemodynamic parameters of rigid laryngoscopy and lighted stylet in patients with coronariopathies.
This randomized clinical trial included 40 patients undergoing myocardial revascularization assigned into two groups: lighted stylet and rigid laryngoscope. Besides time of tracheal intubation in each group, heart rate, mean arterial pressure, changes in ST segment, and central venous pressure were evaluated during patient preparation, 1 minute and 5 minutes after anesthetic induction, and 1 minute after tracheal intubation.
Both groups were homogenous regarding demographic data. Time of tracheal intubation in the rigid laryngoscope group (24 ± 5 sec) was lower than that of the lighted stylet group (28 ± 7 sec), but without significance. Heart rate showed a reduction in both groups during anesthetic induction (p < 0.05), but 1 minute after tracheal intubation the heart rate increased to levels close to baseline levels in both groups (p > 0.05). In the rigid laryngoscope group mean arterial pressure increased after tracheal intubation to levels close to those observed during patient preparation (p > 0.05), while in the lighted stylet group mean arterial pressure remained below baseline levels (p < 0.05). Central venous pressure increased on both groups at all times (p < 0.05).
It was possible to observe that both techniques are safe for tracheal intubation in patients with coronariopathies. However, lighted stylet has fewer repercussions on mean arterial pressure.
