Comparison of Heart Rate Variability Among Tracheal Intubation Methods
Condition: Intubation, Endotracheal
Study type: Observational

Summary: 
      60 patients, in three group of 20 patients each, scheduled for surgery needing general
      anesthesia will be researched. Group A: tracheal intubation of single lumen tube using
      laryngoscope. Group B: single lumen tube using lightwand. Group C: double lumen endobronchial
      cath. During general anesthesia, the spectral power of heart rate variability at three
      periods: (1) preoperation baseline (2) pre-intubation and (3) post-intubation will be
      calculated and compared to investigate the autonomic stimulation effect of different tracheal
      intubation methods.
    

Detailed description: 
      Tracheal intubation is a common practice during general anesthesia. Laryngoscope and
      lightwand are two commonly used methods of tracheal intubation. The autonomic stimulation of
      tracheal intubation may have adverse effect to the patients and have been investigated since
      many years ago. Conventional methods for assessing autonomic activity include measurement of
      blood catecholamine levels or measuring changes of the hemodynamic variables such as heart
      rate and blood pressure. The former is invasive and noncontinuous, and the latter is
      nonspecific and not accurate. Heart rate variability, a parameter derived from the spectral
      power of RR interval sequence in the ECG, is a non-invasive but direct measurement of
      autonomic activity. It is ideal and we will use this in the current research for comparing
      the autonomic activation during tracheal intubation of the two different methods.

      Totally 60 ASA class I-II patients aged 18-65 years will be recruited. 40 of these are
      scheduled for various kind of surgery needing general anesthesia with tracheal intubation of
      single lumen tube. These 40 patients will be randomly assigned into group A and B, each with
      20 patients. In group A the tracheal intubation will be performed by laryngoscope, and in
      group B the intubation performed by lightwand. The other 20 patients of the study, the group
      C, are scheduled for operations needing intubation of double lumen endobronchial cath. The
      intubation will be performed by laryngoscope.

      ECG wil be recorded from at least 5 minutes before induction of general anesthesia and
      continue to at least 10 minutes after tracheal intubation. The induction and maintenance of
      anesthesia will performed as routine practice. The ECG records wil be analyzed offline. Power
      spectrum wil be generated by time-frequency analysis and the heart rate variability
      parameters at three periods (1)preoperation baseline (2) pre-intubation and (3) immediately
      post-intubation will be calculated and compared among the three groups.
    

Intervention name(s): devices for tracheal intubation
Intervention type(s): Device
Intervention description(s): tracheal intubation by laryngoscope or lightwand
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        60 ASA class I-II patients , age 18-65, scheduled for surgery and need general anesthesia
        with tracheal intubation
      
Keywords: heart rate variability, tracheal intubation