Comparison of stress responses to the intubation with lightwand and direct laryngoscope in elderly patients

Objective To compare the effects oflightwand(LW) and direct laryngoscope(DL) in elderly patients undergoing surgery on hemodynamics and stress responses.Methods Forty elderly patients with ASA grade Ⅰ-Ⅱ grade who selective surgery were divided into LW group and DL group by random digits table method,each group with 20 cases.Systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate(HR) were recorded respectively before intubation,30 seconds and 5 minutes after intubation.Extracted patients with peripheral arterial 3 ml at the same time,measured by radioimmunoassay epinephrine and norepinephrine levels.Results The SBP,DBP,HR,epinephrine,norepinephrine 30 seconds after intubation in LW group were significantly lower than those in DL group [(140.50 ± 21.91) mm Hg(1 mm Hg =0.133 kPa) vs.(167.95 ± 17.85) mm Hg,(67.80 ± 6.76) mm Hg vs.(84.15 ±9.89) mm Hg,(85.10 ± 11.76) times/min vs.(96.30 ± 13.72) times/min,(49.47 ± 8.09) ng/L vs.(61.25 ± 9.43) ng/L,(171.27 ± 17.11) ng/L vs.(187.40 ± 16.13) ng/L,P ＜ 0.01].The SBP,epinephrine,norepinephrine 5 minutes after intubation in LW group were significantly lower than those in DL group [(120.75 ± 17.12) mm Hg vs.(136.65 ± 15.43) mm Hg,(39.80 ±7.38) ng/L vs.(47.63 ±8.48) ng/L,(155.93 ± 17.11) ng/L vs.(172.76 ± 13.45) ng/L,P ＜ 0.01].Conclusion Both LW and DL can be well done in elderly patients intubation,but LW can reduce stress responses during the intubation. Key words: Laryngoscopes;  Hemodynamics;  Catecholamines;  Aged;  Lightwand