Skin vasomotor reflex induced by laryngoscopy: comparison of the McCoy and Macintosh blades.

We studied 22 female patients (ASA I or II) to investigate if laryngoscopy and intubation induced the skin vasomotor reflex (SVmR), and to compare the effects of the McCoy and Macintosh blades on the SVmR. Anaesthesia was induced with fentanyl, midazolam, vecuronium and nitrous oxide. In 11 patients, the vocal cords were seen for 3 s with the McCoy blade. Two minutes later, laryngoscopy was performed with the Macintosh blade and the trachea was intubated. In the other 11 patients, the first and second laryngoscopies, respectively, were performed with the Macintosh and McCoy blades. Laryngoscopy alone and intubation with laryngoscopy significantly reduced skin blood flow in the ring finger of all patients (P < 0.01), indicating that both procedures provoked the SVmR. The magnitude of the SVmR and haemodynamic changes did not differ significantly between the two groups.

[1]  T. Cook,et al.  A comparison between the Macintosh and the McCoy laryngoscope blades , 1996, Anaesthesia.

[2]  B. A. Austin,et al.  A comparison of the forces exerted during laryngoscopy , 1996, Anaesthesia.

[3]  P. White,et al.  Comparative Effects of Lidocaine, Esmolol, and Nitroglycerin in Modifying the Hemodynamic Response to Laryngoscopy and Intubation , 1996 .

[4]  R. Mirakhur,et al.  A comparison of the stress response to laryngoscopy , 1995, Anaesthesia.

[5]  T. Kano,et al.  Effects of neural blockade and general anesthesia on the laser-Doppler skin blood flow waves recorded from the finger or toe. , 1994, Journal of the autonomic nervous system.

[6]  T Kano,et al.  Fundamental patterns and characteristics of the laser-Doppler skin blood flow waves recorded from the finger or toe. , 1993, Journal of the autonomic nervous system.

[7]  E. McCoy,et al.  The levering laryngoscope , 1993, Anaesthesia.

[8]  J. Lundvall,et al.  Sympathetic baroreflex control of vascular resistance in comfortably warm man. Analyses of neurogenic constrictor responses in the resting forearm and in its separate skeletal muscle and skin tissue compartments. , 1993, Acta physiologica Scandinavica.

[9]  R. Sapru,et al.  Isosorbide dinitrate spray , 1992, Anaesthesia.

[10]  Y. Ando,et al.  Role of autonomic nerve functions in patients with familial amyloidotic polyneuropathy as analyzed by laser doppler flowmetry, capsule hydrograph, and cardiographic R–R interval , 1992, Muscle & nerve.

[11]  N. Maekawa,et al.  Effect of verapamil on the cardiovascular responses to tracheal intubation. , 1992, British journal of anaesthesia.

[12]  T Yamamura,et al.  Arterial tonometry for noninvasive, continuous blood pressure monitoring during anesthesia. , 1991, Anesthesiology.

[13]  F. Khan,et al.  Quantification of sympathetic vascular responses in skin by laser Doppler flowmetry. , 1991, International journal of microcirculation, clinical and experimental.

[14]  M. Ueda.  [Clinical evaluation of arterial tonometry for noninvasive, continuous blood pressure monitoring during anesthesia]. , 1989, [Hokkaido igaku zasshi] The Hokkaido journal of medical science.

[15]  J. M. McCoy,et al.  Haemodynamic responses to laryngoscopy and tracheal intubation in geriatric patients: Effects of fentanyl, lidocaine, and thiopentone , 1990 .

[16]  J. Himberg,et al.  Pharmacokinetics of Midazolam Following Intravenous and Oral Administration in Patients with Chronic Liver Disease and in Healthy Subjects , 1989, Journal of clinical pharmacology.

[17]  A. Struthers,et al.  The effect of prazosin on skin microcirculation as assessed by laser Doppler flowmetry. , 1988, British journal of clinical pharmacology.

[18]  R. Mirakhur,et al.  Does the choice of the neuromuscular blocking agent affect the cardiovascular response to intubation? , 1987, Acta anaesthesiologica Scandinavica.

[19]  G. Smith,et al.  Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. , 1987, British journal of anaesthesia.

[20]  T. Nagasaka,et al.  Contribution of arteriovenous anastomoses to vasoconstriction induced by local heating of the human finger. , 1987, The Japanese journal of physiology.

[21]  C. Prys‐roberts,et al.  Studies of anaesthesia in relation to hypertension. VII: Adrenergic responses to laryngoscopy. , 1986, British journal of anaesthesia.

[22]  G. Smith,et al.  Plasma catecholamine responses to tracheal intubation. , 1983, British journal of anaesthesia.

[23]  P. Dyck,et al.  Evaluation of skin vasomotor reflexes by using laser Doppler velocimetry. , 1983, Mayo Clinic proceedings.

[24]  L. Saarnivaara,et al.  Attenuation of the Cardiovascular Intubation Response with N2O, Halothane or Enflurane , 1983, Acta anaesthesiologica Scandinavica.

[25]  U. Kautto.  Attenuation of the Circulatory Response to Laryngoscopy and Intubation by Fentanyl , 1982, Acta anaesthesiologica Scandinavica.

[26]  K. Hagbarth,et al.  Regional similarities and differences in thermoregulatory vaso‐ and sudomotor tone. , 1980, The Journal of physiology.

[27]  D. McClain,et al.  Intravenous fentanyl kinetics , 1980, Clinical pharmacology and therapeutics.

[28]  R. Stoelting.  Circulatory changes during direct laryngoscopy and tracheal intubation: influence of duration of laryngoscopy with or without prior lidocaine. , 1977, Anesthesiology.

[29]  J. Biebuyck,et al.  BRITISH JOURNAL OF ANAESTHESIA , 2005 .