Intubation, Endotracheal Clinical Trial
Official title:
Comparison of Autonomic Stimulation Among Different Tracheal Intubation Methods -- Using Non-invasive Heart Rate Variability Spectral Power as an Indicator
60 patients, in three group of 20 patients each, scheduled for surgery needing general anesthesia will be researched. Group A: tracheal intubation of single lumen tube using laryngoscope. Group B: single lumen tube using lightwand. Group C: double lumen endobronchial cath. During general anesthesia, the spectral power of heart rate variability at three periods: (1) preoperation baseline (2) pre-intubation and (3) post-intubation will be calculated and compared to investigate the autonomic stimulation effect of different tracheal intubation methods.
Tracheal intubation is a common practice during general anesthesia. Laryngoscope and
lightwand are two commonly used methods of tracheal intubation. The autonomic stimulation of
tracheal intubation may have adverse effect to the patients and have been investigated since
many years ago. Conventional methods for assessing autonomic activity include measurement of
blood catecholamine levels or measuring changes of the hemodynamic variables such as heart
rate and blood pressure. The former is invasive and noncontinuous, and the latter is
nonspecific and not accurate. Heart rate variability, a parameter derived from the spectral
power of RR interval sequence in the ECG, is a non-invasive but direct measurement of
autonomic activity. It is ideal and we will use this in the current research for comparing
the autonomic activation during tracheal intubation of the two different methods.
Totally 60 ASA class I-II patients aged 18-65 years will be recruited. 40 of these are
scheduled for various kind of surgery needing general anesthesia with tracheal intubation of
single lumen tube. These 40 patients will be randomly assigned into group A and B, each with
20 patients. In group A the tracheal intubation will be performed by laryngoscope, and in
group B the intubation performed by lightwand. The other 20 patients of the study, the group
C, are scheduled for operations needing intubation of double lumen endobronchial cath. The
intubation will be performed by laryngoscope.
ECG wil be recorded from at least 5 minutes before induction of general anesthesia and
continue to at least 10 minutes after tracheal intubation. The induction and maintenance of
anesthesia will performed as routine practice. The ECG records wil be analyzed offline.
Power spectrum wil be generated by time-frequency analysis and the heart rate variability
parameters at three periods (1)preoperation baseline (2) pre-intubation and (3) immediately
post-intubation will be calculated and compared among the three groups.
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Observational Model: Case Control, Time Perspective: Prospective
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