A comparison of hemodynamic changes after endotracheal intubation by usingthe lightwand device and the laryngoscope in normotensive and hypertensivepatients

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 an d TN group; n = 20, respectively) and hypertensive (LH and TH group; n = 20 , respectively) patients. Lightwand or laryngoscopic oral endotracheal intu bation was performed after the induction of anesthesia with fentanyl and pr opofol and muscle relaxation with vecuronium. Systolic blood pressure, dias tolic blood pressure, and heart rate were recorded, and the change from "be fore intubation" to "immediately after intubation" (Delta P) in each variab le was calculated. In normotensive patients, significantly larger Delta P i n systolic blood pressure was observed in the LN group than in the TN group (P < 0.05). In hypertensive patients, there were no significant difference s between the LH group and the TH group in Delta P after intubation. The ti me-to-intubation and number of attempts in the lightwand groups were signif icantly longer and more frequent than those in the laryngoscope groups (P < 0.05). The number of patients who complained of hoarseness was larger in t he 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 normoten sive patients. However, in hypertensive patients, there is no difference in hemodynamic changes between the two techniques. AQ: B after tracheal intub ation than the laryngoscopic technique in normotensive patients. In hyperte nsive patients, however, no difference was found between the two techniques .