title: Comparison of cardiovascular responses to airway management: fiberoptic intubation using a new adapter, laryngeal mask insertion, or conventional laryngoscopic intubation.
abstract: OBJECTIVE
  To evaluate the circulatory effects of fiberoptic intubation with a newly developed mask adapter and to compare these effects with those obtained with a conventional laryngoscope and laryngeal mask airway with general anesthesia.
  
  
  METHODS
  Randomized study.
  
  
  METHODS
  Operating room at a university hospital.
  
  
  METHODS
  30 ASA physical status I adult patients scheduled for minor elective surgery.
  
  
  METHODS
  A Macintosh laryngoscope was used for intubation in Group L (n = 10), a fiberoptic bronchoscope with newly developed mask adapter was used in Group FI (n = 10), and a laryngeal mask airway was used in Group LMA (n = 10). Anesthesia was induced with thiamylal, fentanyl, and vecuronium. Patients were manually ventilated for 4 minutes with sevoflurane. Then their tracheas were intubated with a laryngoscope or fiberoptic bronchoscope, or a laryngeal mask airway was inserted.
  
  
  RESULTS
  Blood pressure (BP) and heart rate (HR) were measured continuously. After intubation, the magnitude of change of both BP and HR was greatest in Group L, next highest in Group FI, and lowest in Group LMA.
  
  
  CONCLUSIONS
  Fiberoptic intubation with general anesthesia using the newly developed mask adapter offers an advantage over the standard laryngoscope for patients in whom pressor response of intubation is potentially hazardous.
authors.affiliation: Department of Anesthesiology, Hokkaido University School of Medicine, Sapporo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Imai
authors.forename: C
authors.initials: C
authors.lastname: Matsumura
authors.forename: Y
authors.initials: Y
authors.lastname: Hanaoka
authors.forename: O
authors.initials: O
authors.lastname: Kemmotsu
mesh_terms: D000328:Adult; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D001794:Blood Pressure / Q000502:physiology*; D002245:Carbon Dioxide / Q000097:blood; D017558:Elective Surgical Procedures; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D017214:Laryngeal Masks; D020704:Laryngoscopes; D008297:Male; D008397:Masks; D008875:Middle Aged; D013511:Minor Surgical Procedures
chemical_list: D002245:Carbon Dioxide