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Study Objectives: To identify the hemodynamic responses to orotracheal intubation using a GlideScope videolaryngoscope (GSVL) in healthy adults, and to determine whether the GSVL could attenuate the hemodynamic response to orotracheal intubation compared with the Macintosh direct laryngoscope (MDLS)., Design: Randomized study., Setting: Operating room, Plastic Surgery Hospital of the Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China., Patients: 57 adult, ASA physical status I patients, scheduled for elective plastic surgery during general anesthesia requiring orotracheal intubation., Interventions: Patients were randomly allocated to either the GSVL group (n = 30) or the MDLS group (n = 27). Anesthesia was induced with intravenous injection of fentanyl 2 microg/kg, propofol 2 mg/kg, and vecuronium 0.1 mg/kg. Orotracheal intubation was started two minutes after vecuronium injection. All intubation procedures were performed by a single anesthesiologist experienced in using an MDLS and a GSVL. After intubation, anesthesia was maintained with 1% isoflurane and 60% nitrous oxide in oxygen., Measurements and Main Results: Noninvasive blood pressure (BP) and heart rate (HR) were recorded before (baseline values) and immediately after induction (postinduction values), at intubation, and for 5 minutes at one-minute intervals. Maximal BP and HR values during the observation and intubation times were also noted. The product of HR and systolic BP (ie, the rate-pressure product [RPP]) was calculated. Intubation time was significantly longer in the GSVL group than in the MDLS group (P < 0.01). Except for maximal value of diastolic BP in the GSVL group, increases in BPs during the observation in the two groups did not significantly exceed baseline values (P > 0.05). In the GSVL group, HR and RPP at intubation were significantly higher than their baseline values, and HR increases lasted for 4 minutes. In the MDLS group, HR at intubation was also significantly higher than its baseline value, but the tachycardic response lasted only for 1 minute. During the observation, there were no significant differences between the two groups in BPs, HRs, or RPPs at any time points or in their maximal values., Conclusions: The hemodynamic responses to orotracheal intubation using a GSVL and an MDLS were similar. The GSVL had no any special advantage over the MDLS in attenuating the hemodynamic responses to orotracheal intubation.

Background: The purposes of this study were to further identify the hemodynamic responses to orotracheal intubation in children, using a fiberoptic bronchoscope (FOB) and a direct laryngoscope (DLS), and to validate whether the FOB can attenuate the hemodynamic response to orotracheal intubation compared with the DLS., Methods: Forty-three children, ASA PS I-II scheduled for elective plastic surgery under general anesthesia requiring orotracheal intubation were randomly allocated to either the DLS group (n = 20) or the FOB group (n = 23). Noninvasive systolic blood pressure (SBP) and heart rate (HR) were recorded before (baseline values) and after anesthesia induction (postinduction values), at intubation and every minute for the first 5 min after intubation. The maximal values of SBP and HR during the observation were also recorded. The product of HR and SBP [rate pressure product (RPP)] at each time point was calculated., Results: In the DLS group, SBP, HR, and RPP at intubation and 1 min after intubation were significantly higher than postinduction values, but did not exceed baseline values. In the FOB group, SBP, HR, and RPP at intubation increased significantly compared with baseline and postinduction values. In the two groups, the maximal values of SBP, HR, and RPP during the observation were significantly higher than baseline values. Except for the HR at intubation, there were no significant differences in other hemodynamic parameters during the observation and the time required to reach maximal values of SBP, HR, and RPP between the two groups., Conclusions: Orotracheal intubation using FOB and DLS in children may cause similar increases in SBP and HR. Compared with the DLS, the FOB had no advantage in attenuating the hemodynamic responses to orotracheal intubation.

Objective: To compare the hemodynamic responses to orotracheal intubation with GlideScope videolaryngoscope (GSVL) and with fiberoptic bronchoscope (FOB) after induction of general anesthesia., Methods: Totally 57 ASA physical status I - II adult patients undergoing elective plastic surgery and requiring orotracheal intubation were randomly allocated to either GSVL group (n = 29) or FOB group (n = 28). After a routine intravenous anesthetic induction, orotracheal intubation was performed. Noninvasive blood pressure (BP) and heart rate (HR) were recorded before and after anesthetic induction, at intubation and thereafter at 1 minute interval for 5 minutes., Results: The intubation time was not significantly different between the two groups (P > 0.05). After intubation, BP and HR exhibited significant increases compared to the post-induction values in both groups, but the maximum values of BP did not exceed the pre-induction values while the maximum value of HR was higher than the pre-induction value. During the observation, BP and HR at all time points as well as the maximum values of BP and HR had no significant differences between the two groups (P > 0.05)., Conclusion: The orotracheal intubations using FOB and GSVL result in similar hemodynamic responses.

Background and Objective: The GlideScope videolaryngoscope is a newly developed laryngoscope for tracheal intubation recently introduced into clinical anaesthesia. In this randomised clinical study, we compared the haemodynamic responses to orotracheal intubation using a GlideScope videolaryngoscope and a fibreoptic bronchoscope., Methods: Fifty-six adult patients, ASA I-II scheduled for elective plastic surgery under general anaesthesia requiring orotracheal intubation were randomly allocated to either the GlideScope videolaryngoscope group or the fibreoptic bronchoscope group. After a standard intravenous anaesthetic induction, orotracheal intubation was performed. Noninvasive blood pressure and heart rate were recorded before and after induction, at intubation and for 5 min after intubation at 1 min intervals., Results: As compared with the post-induction values the orotracheal intubations using a fibreoptic bronchoscope and a GlideScope videolaryngoscope resulted in the significant increases in blood pressures which did not exceed their baseline values. In the two groups, heart rates at intubation and within 2 min after intubation were significantly higher than their baseline values. However, there were no significant differences in blood pressures and heart rates at all time points, their maximal values and maximal percent changes during the observation and the times required to reach their maximal values between the two groups., Conclusions: The orotracheal intubations using a fibreoptic bronchoscope and a GlideScope videolaryngoscope produce similar haemodynamic responses.

Objective: To compare the hemodynamic responses to orotracheal intubation via fiberoptic bronchoscope (FOB) with conventional orotracheal intubation via direct laryngoscope (DLS) in children under general anesthesia., Methods: Forty-three American Society of Anesthesiologist grade I-II children undergoing the elective plastic surgery and requiring orotracheal intubation were randomly allocated to either the DLS group (n = 20)or the FOB group (n = 23). After standard intravenous anesthetic induction, orotracheal intubation was performed using a DLS or a FOB. Noninvasive systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and rate-pressure product (RPP) were recorded before and after anesthetic induction, at intubation, and 5 minutes after intubation with 1 minute interval., Results: In the DLS group, SBP, HR, and RPP at intubation increased significantly compared to their postinduction values (P < 0.05),but blood pressure, HR and RPP at intubation didn't differ from their preinduction values. The maximal values of SBP, HR and RPP during the observation (from the beginning of intravenous anesthetic induction to 5 minutes after intubation) were significantly higher than their preinduction values (P < 0.05). In the FOB group, blood pressure, HR and RPP at intubation increased significantly compared to their preinduction and postinduction values (P < 0.05), and the maximal values of blood pressure, HR and RPP during the observation were significantly higher than their preinduction values (P < 0.05). There were no significant differences in blood pressure and RPP at each time point during the observation between the two groups. The HR at intubation were significantly higher in the FOB group than in the DLS group (P < 0.05), but no significant difference was observed in the HR values at other time points during the observation between the two groups. There were also no significant differences in the maximal values of blood pressure, HR and RPP or the times to reach their maximal values between the two groups., Conclusion: General anesthesia of clinical standard depth can not effectively inhibit the pressor and tachycardiac responses caused by fiberoptic orotracheal intubation in children. As compared with DLS, FOB has no special advantages in preventing the cardiovascular stress responses to orotracheal intubation in children.