Dr Asha Sharma, Dr S P Chittora


Aim: The aim of study was to compare the effects of nasotracheal intubation on cardiovascular responses when the appropriate
moment for intubation was directed by either clinical judgment or train-of-four assessment.
Method: 60 normotensive, ASA grade I &II patients, aged 18 to 60 years, scheduled for elective maxillofacial surgery under
general anaesthesia selected. In Group M patients, intubation was done after train of four counts became zero in adductor pollicis
muscle, in Group C the intubation was done after the clinical judgment of jaw muscle relaxation. Changes in heart rate (HR) and
mean arterial pressure, intubating conditions and the time between the administration of a neuromuscular blocking agent and
intubation were recorded.
RESULT The two groups were comparable in demographic parameters. HR and mean arterial pressure were significantly higher in
Group C as compared to Group M after intubation (P < 0.05). The mean time required for intubation was significantly shorter in
Group C compared to Group M (193 ± 7 s vs. 403 ± 101 s). Excellent and good intubation conditions were observed in all Group M
patients, But in 22 out of 30 patients (73%) of Group C.
CONCLUSION: Haemodynamic responses to nasotracheal intubation can be significantly attenuated if nasotracheal intubation is
based on neuromuscular monitoring of adductor pollicis muscle.


Haemodynamic, neuromuscular monitor, tracheal intubation,

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