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Indian Journal of Anesthesia and Analgesia

Volume  7, Issue 3, May-June 2020, Pages 697-702
 

Original Article

Haemodynamic Response To Fiberoptic Nasotracheal Intubation Under General Anaesthesia

Tushar D Bhavar , Himanshu Khanapurkar, Suhit Natekar

1Associate professor, 2 Resident, 3Assistant Professor, Department of Anesthesia, Rural Medical College, Pravara Institute of Medical Sciences, Loni, Maharashtra 413736, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7320.6

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 intubation using FOB. Aim and Objectives: To observe haemodynamic response to nasotracheal intubation under general anaesthesia using fiberoptic bronchoscopy 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 sleeted for nasotracheal intubation with FOB. 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 fiberoptic bronchoscope. SpO2 was continuously monitored and patients maintained 100% saturation during induction, at the time of insertion of FOB, 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 FOB was 69.52 sec.

Conclusion: Fiberoptic bronchoscope under general anesthesia causes signicant increases in blood pressure and heart rate


Keywords : Nasotracheal intubation, General Anaesthesia, Hemodynamic Responses, Fibreoptic Bronchoscope, Difficult Intubation.
Corresponding Author : Tushar D Bhavar