Compariaon Of Stress Responses To The Treacheal Intubation With Lightwand And Direct Laryngoscope In Elderly Patients

Objective: To compare the effects of lightwand(LW) and direct laryngoscope(DL) in elderly patients undergoing surgery on hemodynamics and stress responses.Method: 40 cases of elderly patients under general anesthesia in the elective surgery were selected, all subjective were characterized as follow: ASAⅠ-Ⅱ, 60-75 years age, 45-75kg in weight and 150-175㎝ in height. The patients were randomly divided into two groups: group of laryngoscope (group A) and group of lightwand (group B) . There are 20 cases in each groups. In group A, direct laryngoscope was used to intubate during the induction of general anesthesia ; In group B, lightwand(LW) was used to intubate during the induction of general anesthesia. SBP,DBP,HR were recorded respectively at various times.Blood samples were taken at various times(before anesthesia induction,30 seconds and 5 minutes after intubation) for measurements of epinephrine(AE) and norepinephrine(NE) levels with radioimmunoassay.Results: Compared the general conditions such as age,sex, weight ,height, intubation duration etc, there are no statistical significance in these two groups(P>0.05). Compared to group B, SBP and epinephrine(AE) and norepinephrine(NE) levels of plasma at various times after intubation was ascended obviously in group A, the difference is statistically significant(P<0.05);DBP,HR at 30 seconds after intubation was ascended obviously in group A, the difference is statistically significant(P<0.05);But the difference of DBP,HR at 5 minutes after intubation is no statistically significant (P>0.05); Compared with before intubation, epinephrine(AE) and norepinephrine(NE) levels of plasma at 30 seconds after intubation was ascended obviously in these two groups,the difference is statistically significan(tP<0.05); The difference of epinephrine(AE) and norepinephrine(NE) levels of plasma at 5 minutes after intubation is no statistically significant in group B(P>0.05);But the difference of epinephrine(AE) and norepinephrine(NE) levels of plasma at 5 minutes after intubation is statistically significant in group A(P<0.05);Compared with before intubation, SBP,DBP at 30 seconds after intubation was ascended obviously in group A , the difference is statistically significant(P<0.05); SBP,DBP at 5 minutes after intubation was reduced obviously in group B ,the difference is statistically significant(P<0.05);HR at 30 seconds after intubation was ascended obviously in group A ,the difference is statistically significant(P<0.05);The difference of SBP,DBP and HR at other times after intubation is no statistically significant in two groups(P>0.05).Conclusions:Compared with direct laryngoscope, hemodynamics were kept stable with less stress response during lightwand intubation under general anesthesia in elderly patients undergoing surgery .