Abstract: Objective To observe the effects of endotracheal tube with injecting medicine to endotracheal and laryngopharynx for topical anesthesia, transcutaneous electrical acupoint stimulation (TEAS), and endotracheal-laryngopharynx for topical anesthesia combined with TEAS on hemodynamics during intubation. Methods One hundred patients that belonged to American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱ, in accordance with the random number table, were categorized into four groups (n=25). They were endotracheal tube (group A), endotracheal tube with injecting medicine to endotracheal and laryngopharynx (group B), TEAS combined with endotracheal tube (group C) and endotracheal tube with injecting medicine to endotracheal and laryngopharynx combined with TEAS (group D). All patients were monitored continuously on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), systemic vascular resistance index (SVRI) and bispectral index (BIS) respectively in the calm state at timepoints of entering the operation room (T0), before tracheal intubation after intravenous induce anesthetics (T1), immediately after tracheal intubation (T2), 3 min after tracheal intubation (T3), 5 min after tracheal intubation (T4) and 10 min after tracheal intubation (T5). Results ① Compare with timepoint T0, SBP was decreased markedly (P<0.05) at T1 in each group. At T2, T3 and T4, SBPs were increased 26%, 36% and 34% (P<0.01) in group A. SBPs were increased 28% (P<0.01), 20% (P<0.01) and 9% (P<0.05) in group B. SBPs were increased 25%, 27% and 21% (P<0.01) in group C. SBPs were increased 16% (P<0.01), 16% (P<0.01) and 9% (P<0.05) than T1 respectively. Among groups at same time, SBPs at T3 and T4 were decreased 12% (P<0.05) and 19% (P<0.01) in group B, were decreased 9% (P<0.05) and 12% (P<0.01) in group C, were decreased 14% (P<0.05) and 19% (P<0.01) in group D. At T2, SBP of group D were 8% (P<0.05), 8% (P<0.05) and 4% (P<0.05) lower than the SBP values of group A, B and C respectively. At T4, the value of SBP in group D was 7% lower than the value in group C (P<0.05). ② HR: in all groups, the HR values at T1 (P<0.05) were markedly lower than the values at T0. The HR values of group A at T2, T3 and T4 were 30%, 49% and 44% higher than the value at T1(P<0.01). The HR values of group B were 36%, 21% and 11% higher than the value at T1 (P<0.01). The HR values of group C are 19% (P<0.01), 35% (P<0.01) and 17% (P<0.05) higher than the value at T1. The HR values of group D were 14%, 17% (P<0.01) and 9% (P<0.05) higher than the value at T1. The extent of increasing in group D was smaller than the extents in other groups. ③ CI: in all groups, CI values at T1 were lower than the values at T0 (P<0.01). The values at T2 were 18% (P<0.01), 8%, 8% (P<0.05) and 6% lower than the value at T0. CI values in groupB, C and D at T3 were close to values at T0. But the value at T3 in group A was 15% lower than the value at T0 (P<0.01). There were no significant differences of CI values at T0 and T1 among groups. At T2, T3, CIs in group D were 13% and 12% lower (P<0.05) than A. ④ SVRI: in all groups, SVRI values at T1 were lower than values at T0 (P<0.05). The SVRI value of group C at T3 was 27% higher than the SVRI value at T1 of group C. The SVRI values of group D at T2 and T3 were 15% and 12% (P<0.05) higher than the values at T1 of group D respectivley. CI values of group D at T2 and T3 were 14% and 10% (P<0.05) higher than values in of group A at T2 and T3 respectively. ⑤ BIS: compared with T0, the differences among four groups at T1-T5 were statistically significant (P<0.01). There was no significant differences among four groups at each time point (P>0.05). Conclusions Both endotracheal tube with injecting medicine to endotracheal and laryngopharynx for topical anesthesia and TEAS can reduce excessive hemodynamic responses during the intubation to some extent, but combination of them will has better effect.
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