Hemodynamic and Catecholamine Responses to Laryngoscopy and Endotracheal Intubation in Paraplegic Patients: Time Course and Relation to the Affected Level / 대한마취과학회지

ABSTRACT

BACKGROUND: We determined whether the cardiovascular responses to endotracheal intubation change as a function of the time elapsed after injury and the level of injury in patients with spinal cord injury. METHODS: One-hundred-eighty six patients with complete cord injury were grouped into 3 according to the level of injuryhigh- (T1-T4, n = 34), mid- (T5-T10, n = 47) and low paraplegics ( 10 yrs.Twenty-five patients with no cord injury served as controls.Systolic arterial blood pressure (SAP), heart rate (HR), and plasma catecholamine concentrations were measured. RESULTS: The intubation caused an increase of SAP and norepinephrine concentrations in every group.However, the magnitude of their peak increases was less in high paraplegics compared with all other groups (P < 0.05).HR was similarly increased in all groups (P < 0.01).Pressure but not either HR or norepinephrine response was enhanced in mid- and low-paraplegics whose injury elapsed more than 10 yrs compared with controls (P < 0.05).The incidence of arrhythmias did not differ among the groups. CONCLUSIONS: The pressure and plasma catecholamine changes associated with endotracheal intubation may be attenuated in high-paraplegics, and the pressure changes may be enhanced over time in mid- and low-paraplegics.