Blood pressure and heart rate changes during awake fiberoptic nasotracheal intubation.

Hypertension and tachycardia associated with orotracheal intubation may result from direct laryngoscopy (1,2), placement of the endotracheal tube (1,2), and succinylcholine if used (3). With awake fiberoptic nasotracheal intubation (FNI) the stimulation of rigid laryngoscopy and succinylcholine are avoided. All elective nasotracheal intubations in our institution are performed with the patient sedated and using topical anesthesia and a flexible fiberscope. This report analyzes changes in mean arterial pressure (MAP) and heart rate (HR) during 200 such intubations to determine whether avoidance of rigid laryngoscopy and succinylcholine decreases the incidence and the severity of hypertension and tachycardia that are associated with tracheal intubation.

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