A comparison of haemodynamic responses between clinical assessment-guided nasotracheal intubation and neuromuscular block monitoring-guided nasotracheal intubation : A Prospective, Randomised Study

Dr Asha Sharma; Dr S P Chittora

Volume : VII, Issue : X, October - 2018

A comparison of haemodynamic responses between clinical assessment-guided nasotracheal intubation and neuromuscular block monitoring-guided nasotracheal intubation : A Prospective, Randomised Study

Dr Asha Sharma, Dr S P Chittora

Abstract :

AimThe aim of study was to compare the effects of nasotracheal intubation on cardiovascular responses when the appropriate moment for intubation was directed by either clinical judgment or train–of–four assessment.Method60 normotensive, ASA grade I &II patients, aged 18 to 60 years, scheduled for elective maxillofacial surgery under general anaesthesia selected. In Group M patients, intubation was done after train of four counts became zero in adductor pollicis muscle,in Group C the intubation was done after the clinical judgment of jaw muscle relaxation. Changes in heart rate (HR) and mean arterial pressure, intubating conditions and the time between the administration of a neuromuscular blocking agent and intubation were recorded.Result The two groups were comparable in demographic parameters. HR and mean arterial pressure were significantly higher in Group C as compared to Group M after intubation (P< 0.05). The mean time required for intubation was significantly shorter in Group C compared to Group M (193 ± 7 s vs. 403 ± 101 s). Excellent and good intubation conditions were observed in all Group M patients, But in 22 out of 30 patients (73%) of Group C.Conclusion Haemodynamic responses to nasotracheal intubation can be significantly attenuated if nasotracheal intubation is based on neuromuscular monitoring of adductor pollicis muscle.