Avaliação dos parâmetros hemodinâmicos entre a laringoscopia rígida e o estilete luminoso em pacientes coronariopatas

Marcello Fonseca Salgado Filho; Victor Hugo Cordeiro; Suzana Mota; Marina Prota; Marina Natalino Lopez; Renzo A. de Lara

doi:10.1590/S0034-70942011000400006

Scientific Article

Avaliação dos parâmetros hemodinâmicos entre a laringoscopia rígida e o estilete luminoso em pacientes coronariopatas

Comparison between the hemodynamic parameters of rigid laryngoscopy and lighted stylet in patients with coronariopathies

Marcello Fonseca Salgado Filho; Victor Hugo Cordeiro; Suzana Mota; Marina Prota; Marina Natalino Lopez; Renzo A. de Lara

http://dx.doi.org/10.1590/S0034-70942011000400006 Braz J Anesthesiol, vol.61, n4, p.451-455, 2011

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Resumo

PACIENTES E MÉTODOS: Ensaio clínico randomizado conduzido em 40 pacientes submetidos à revascularização do miocárdio alocados em dois grupos: estilete luminoso e laringoscópio rígido. Avaliaram-se frequência cardíaca, pressão arterial média, alterações do segmento ST e pressão venosa central durante o preparo do paciente, 1 minuto e 5 minutos após a indução anestésica e 1 minuto após a intubação traqueal, além do tempo de intubação traqueal em cada grupo. RESULTADOS: Os grupos mostraram-se homogêneos em relação aos dados demográficos. O tempo de intubação traqueal para o grupo laringoscópio rígido (24 ± 5 s) foi menor que no grupo estilete luminoso (28 ± 7 s), porém sem significância. A frequência cardíaca diminui nos dois grupos durante a indução (p < 0,05), mas 1 minuto após a intubação, a frequência cardíaca aumentou para valores próximos ao momento do preparo em ambos os grupos (p > 0,05). No grupo laringoscópio rígido, a pressão arterial média aumentou após a intubação traqueal para valores próximos ao momento do preparo do paciente (p > 0,05), enquanto no grupo estilete luminoso a pressão arterial média ficou abaixo dos valores basais (p < 0,05). A pressão venosa central aumentou em ambos os grupos em todos os momentos (p < 0,05). CONCLUSÕES: Neste estudo, é possível observar que ambas as técnicas são seguras para intubação traqueal em pacientes coronariopatas. Contudo, o estilete luminoso apresenta menor repercussão na pressão arterial média.

Palavras-chave

DOENÇAS, EQUIPAMENTOS, INTUBAÇÃO TRAQUEAL, TÉCNICAS DE MEDIÇÃO

Abstract

BACKGROUND AND OBJECTIVE: Anesthesiologists are responsible for airway management whenever they assume the anesthesia of a patient. In this study, we compare the hemodynamic parameters of rigid laryngoscopy and lighted stylet in patients with coronariopathies. PATIENTS AND METHODS: This randomized clinical trial included 40 patients undergoing myocardial revascularization assigned into two groups: lighted stylet and rigid laryngoscope. Besides time of tracheal intubation in each group, heart rate, mean arterial pressure, changes in ST segment, and central venous pressure were evaluated during patient preparation, 1 minute and 5 minutes after anesthetic induction, and 1 minute after tracheal intubation. RESULTS: Both groups were homogenous regarding demographic data. Time of tracheal intubation in the rigid laryngoscope group (24 ± 5 sec) was lower than that of the lighted stylet group (28 ± 7 sec), but without significance. Heart rate showed a reduction in both groups during anesthetic induction (p < 0.05), but 1 minute after tracheal intubation the heart rate increased to levels close to baseline levels in both groups (p > 0.05). In the rigid laryngoscope group mean arterial pressure increased after tracheal intubation to levels close to those observed during patient preparation (p > 0.05), while in the lighted stylet group mean arterial pressure remained below baseline levels (p < 0.05). Central venous pressure increased on both groups at all times (p < 0.05). CONCLUSIONS: It was possible to observe that both techniques are safe for tracheal intubation in patients with coronariopathies. However, lighted stylet has fewer repercussions on mean arterial pressure.

Keywords

Laryngoscopes, Intubation, Intratracheal, Coronary disease, Hemodynamics

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Avaliação dos parâmetros hemodinâmicos entre a laringoscopia rígida e o estilete luminoso em pacientes coronariopatas

Comparison between the hemodynamic parameters of rigid laryngoscopy and lighted stylet in patients with coronariopathies

Marcello Fonseca Salgado Filho; Victor Hugo Cordeiro; Suzana Mota; Marina Prota; Marina Natalino Lopez; Renzo A. de Lara

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