Haemodynamic responses to nasotracheal intubation under general Anaesthesia

Abstract

Introduction: The cardiovascular response to tracheal intubation, although transient, may be harmful to some patients, mainly those with myocardial or cerebrovascular disease. So we have conducted a study to find out hemodynamic effect of nasotracheal intubation. Aim and Objectives: To observe haemodynamic response to nasotracheal intubation under general anaesthesia using a direct laryngoscope with respect to: Haemodynamic changes during intubation, at the time of & after intubation; Time required for intubation; Saturation; Post extubation epistaxis. Methodology: 50 ASA grade I and II patients of both sexes in the age group of 18-60 years scheduled for an elective surgery under general anesthesia were selected for nasotracheal intubation with a direct laryngoscope. A uniform protocol of anesthesia was used. Measurements: Heart Rate [HR], Systolic Blood Pressure [SBP], Diastolic Blood Pressure [DBP] & Mean Arterial Pressure [MAP]were noted at their baseline, post-induction values, at the time of insertion of the scope, immediately after intubation & at 3, 5 and 10 minutes after intubation. Result: Haemodynamic response in the form tachycardia, increase in SBP, DBP & MAP occurred in nasotracheal intubations with the direct laryngoscope. Spo2 was continuously monitored and patients maintained 100% saturation during induction, at the time of insertion of laryngoscope, at 3min, 5min and 10 min. 8 patients had lower reading immediately after intubation with mean Spo2 of 98.72%. Mean time for intubation using laryngoscope was18.2sec. Conclusion: Direct laryngoscope nasotracheal intubation causes significant increases in blood pressure and heart rate.