COMPARISON OF CARDIOVASCULAR-RESPONSES TO AIRWAY MANAGEMENT - FIBEROPTIC INTUBATION USING A NEW ADAPTER, LARYNGEAL MASK INSERTION, OR CONVENTIONAL LARYNGOSCOPIC INTUBATION

Study Objectives: To evaluate the circulatory effects of fiberoptic in tubation with a newly developed mask adapter and to compare these effe cts with those obtained with a conventional laryngoscope and laryngeal mask airway with general anesthesia. Design: Randomized study. Settin g: Operating room at a university hospital. Patients: 30 ASA physical status I adult patients scheduled for minor elective surgery. Interven tions: A Macintosh laryngoscope was used for intubation in Group L (n = 10), a fiberoptic bronchoscope with newly developed mask adapter was used in Group FI (n = 10), and a laryngeal mask airway was used in Gr oup LMA (n = 10). Anesthesia was induced with thiamylal, fentanyl, and vecuronium. Patients were manually ventilated for 4 minutes with sevo flurane. Then their tracheas were intubated with a laryngoscope or fib eroptic bronchoscope, or a laryngeal mask airway was inserted. Measure ments and Main Results: Blood pressure (BP) and heart rate (HR) were m easured continuously. After intubation, the magnitude of change of bot h BP and HR was greatest in Group L, next highest in Group FI, and low est in Group LMA.Conclusion: Fiberoptic intubation with general anesth esia using the newly developed mask adapter offers an advantage over t he standard laryngoscope for patients in whom presser response of intu bation is potentially hazardous.