A Comparative Study on the Effect of Endotracheal Intubation in Three Methods of Oral, and Nasal with and without the Help of Magill Forceps, on Heart Rate and Blood Pressure in Patients Undergoing Maxillofacial Surgery

Document Type : Original Article (s)

Authors

1 Professor, Department of Anesthesiology, School of Medicine AND Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Anesthesiology, School of Medicine AND Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Associate Professor, Department of Anesthesiology, School of Medicine AND Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The purpose of this study was to compare the effect of endotracheal intubation in three methods of oral, and nasal with and without the help of Magill forceps, on heart rate and blood pressure in patients undergoing maxillofacial surgery.Methods: In this single-blind randomized clinical trial study, 96 patients who underwent facial and maxillofacial surgery, were randomly divided into three groups of oral, and nasal (with or without the use of Magill forceps) endotracheal intubation. Heart rate and blood pressure were studied in patients before the intubation, and 0, 1, 2, 5, and 10 minutes after it, and post-tubal complications were assessed as well.Findings: There was no significant difference between the three groups based on heart rate, and systolic and diastolic blood pressure (P > 0.05 for all). Throat wound in the oral intubation group, and epistaxis in nasal intubation group without help of Magill forceps was significantly higher than in other groups (P < 0.05). Moreover, the duration of intubation in the oral procedure was significantly lower than other methods (P < 0.05).Conclusion: All three methods of oral, and nasal, with and nose without the help of Magill forceps, cause similar changes in heart rate and blood pressure. The only difference between these three methods is the side effects caused by intubation.

Keywords

References

  1. Sharma S, Majumder K, Kishor K, Das R, Kishor S, Gulia S. Relevance of predictors in difficult intubation for patients undergoing maxillofacial surgery. Int J Clin Med 2014; 5(21): 1365-73.
  2. Shiga T, Wajima Z, Inoue T, Sakamoto A. Predicting difficult intubation in apparently normal patients: A meta-analysis of bedside screening test performance. Anesthesiology 2005; 103(2): 429-37.
  3. Karkouti K, Rose DK, Wigglesworth D, Cohen MM. Predicting difficult intubation: A multivariable analysis. Can J Anaesth 2000; 47(8): 730-9.
  4. Lee A, Fan LT, Gin T, Karmakar MK, Ngan Kee WD. A systematic review (meta-analysis) of the accuracy of the Mallampati tests to predict the difficult airway. Anesth Analg 2006; 102(6): 1867-78.
  5. Fating DR, Dandekar A, Tirpude NG. Role of IV Nalbuphine in attenuation of haemodynamic response to laryngoscopy and endotracheal intubation. Indian Journal of Clinical Anaesthesia 2016; 3(2): 165-9.
  6. Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth 1987; 59(3): 295-9.
  7. Danial N, Yeldho J. Effect of intravenous lornoxicam on the haemodynamic response following laryngoscopy and intubation. Paripex-Indian Journal of Research 2018; 7(5): 1-4.
  8. Russell WJ, Morris RG, Frewin DB, Drew SE. Changes in plasma catecholamine concentrations during endotracheal intubation. Br J Anaesth 1981; 53(8): 837-9.
  9. Oczenski W, Krenn H, Dahaba AA, Binder M, El-Schahawi-Kienzl I, Jellinek H, et al. Hemodynamic and catecholamine stress responses to insertion of the Combitube, laryngeal mask airway or tracheal intubation. Anesth Analg 1999; 88(6): 1389-94.
  10. Kanchi M, Nair HC, Banakal S, Murthy K, Murugesan C. Haemodynamic response to endotracheal intubation in coronary artery disease: Direct versus video laryngoscopy. Indian J Anaesth 2011; 55(3): 260-5.
  11. Crawford DC, Fell D, Achola KJ, Smith G. Effects of alfentanil on the pressor and catecholamine responses to tracheal intubation. Br J Anaesth 1987; 59(6): 707-12.
  12. Abou-Arab MH, Feiner JR, Spigset O, Heier T. Alfentanil during rapid sequence induction with thiopental 4 mg/kg and rocuronium 0.6 mg/kg: tracheal intubation conditions. Acta Anaesthesiol Scand 2015; 59(10): 1278-86.
  13. Takahashi S, Mizutani T, Miyabe M, Toyooka H. Hemodynamic responses to tracheal intubation with laryngoscope versus lightwand intubating device (Trachlight) in adults with normal airway. Anesth Analg 2002; 95(2): 480-4, table.
  14. Kuhn F. Die pernasale tubage. München Med Wochenschr 1902; 49: 1456.
  15. Magill IW. Technique in endotracheal anaesthesia. Br Med J 1930; 2(3645): 817-9.
  16. Mali A, Solanki JA, Deshpande CM. Comparison of the endotracheal cuff inflation techniques and its postoperative laryngotracheal morbidity: An observational study. International Journal of Research in Medical Sciences; 2017; 5(2): 491-5.
  17. Keen RI, Kotak PK, Ramsden RT. Anaesthesia for microsurgery of the larynx. Ann R Coll Surg Engl 1982; 64(2): 111-3.
  18. Fan CH, Peng B, Zhang FC. Influence of laryngeal mask airway (LMA) insertion anesthesia on cognitive function after microsurgery in pediatric neurosurgery. Eur Rev Med Pharmacol Sci 2017; 21(4 Suppl): 37-42.
  19. Singh S, Smith JE. Cardiovascular changes after the three stages of nasotracheal intubation. Br J Anaesth 2003; 91(5): 667-71.
  20. Saghaei M. Random allocation software for parallel group randomized trials. BMC Med Res Methodol 2004; 4: 26.
  21. Ueki R, Komasawa N, Hirose M, Kaminoh Y. Simulation study of nasotracheal and orotracheal fiberoptic intubation with the Aintree Intubation Catheter. Acute Med Surg 2015; 2(4): 263-6.
  22. Smith JE, Grewal MS. Cardiovascular effects of nasotracheal intubation. Anaesthesia 1991; 46(8): 683-6.
  23. Liu HP, Xue FS, Li XY, Xu YC, Yang QY. Comparison of cardiovascular responses between orotracheal and nasotracheal intubation with the aid of GlideScope video laryngoscope. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 2008; 20(7): 405-8. [In Chinese].
  24. Shibata Y, Okamoto K, Matsumoto M, Suzuki K, Sadanaga M, Morioka T. Cardiovascular responses to fiberoptic intubation: A comparison of orotracheal and nasotracheal intubation. J Anesth 1992; 6(3): 262-8.
  25. Holzapfel L. Nasal vs oral intubation. Minerva Anestesiol 2003; 69(5): 348-52.
Journal of Isfahan Medical School
Volume 36, Issue 499 - Serial Number 499
September and October 2018
Pages 1219-1226

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History

  • Receive Date: 15 August 2018
  • Revise Date: 29 April 2024
  • Accept Date: 06 April 2022

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