Disease relevance of Laryngoscopy

• RA duration and severity, prior laryngeal symptoms, and abnormalities detected by concurrent indirect laryngoscopy (IL) and computerized tomography (CT) were noted and correlated with changes of basilar interstitial fibrosis (BPF) found by chest radiograph [1].
• The pressor response and tachycardia observed during laryngoscopy and tracheal intubation were, thus, successfully prevented by lidocaine aerosolization [2].
• Severe bradycardia or even asystole is possible with fentanyl analogues, especially in conjunction with the vagal stimulating effects of laryngoscopy [3].
• No patient in the aerosolized lidocaine group developed any premature ventricular contraction (PVC), but 4 of 10 patients in the control group had 2 to 3 PVCs during laryngoscopy and intubation [2].
• A plasma fentanyl concentration of 1 ng/ml (3 ng/ml) resulted in a 31-34% (50-55%) reduction of the propofol Cp50s for tetanus, laryngoscopy, intubation, and skin incision [4].

Psychiatry related information on Laryngoscopy

• Vocal cord movement was analyzed by fiberoptic laryngoscopy during wakefulness and diazepam-induced sleep (sleep load test) [5].

High impact information on Laryngoscopy

• This finding, in conjunction with evidence of airway injury such as seen on laryngoscopy, strongly supports the relation between GER and airway disease [6].
• Laryngoscopy is recommended if hoarseness occurs during treatment with fluticasone [7].
• The results confirmed previous reports of the accuracy and value of transaxial CT and direct laryngoscopy, but indicated that coronal and sagittal reconstruction as well as linear tomography added no significant information [8].
• Pharmacodynamic interaction between propofol and remifentanil regarding hypnosis, tolerance of laryngoscopy, bispectral index, and electroencephalographic approximate entropy [9].
• RESULTS: Remifentanil alone had no appreciable effect on response to shaking and shouting or response to laryngoscopy [9].

Chemical compound and disease context of Laryngoscopy

• We compared the hemodynamic response to laryngoscopy and intubation, as well as emergence and recovery times, when propofol or thiopental were used for rapid intravenous induction of anesthesia in 59 infants undergoing repair of inguinal hernia [10].
• Hypotension (SAP < 100 mm Hg) occurred in four patients in group R and three patients in group A. CONCLUSIONS: Remifentanil and alfentanil similarly attenuate the pressor response to laryngoscopy and intubation, but the incidence of hypotension confirms that both drugs should be used with caution in elderly patients [11].
• The purpose of this study was to evaluate intravenous nitroglycerin given during induction of anesthesia as a means for prevention of myocardial ischemia and hemodynamic changes associated with induction, laryngoscopy, and intubation, in patients with stable angina scheduled for vascular operations of moderate duration [12].
• Induction of anaesthesia with sevoflurane and low-dose remifentanil: asystole following laryngoscopy [13].
• Haemodynamic changes (supraventricular tachycardia, decreases in arterial pressure) were observed during laryngoscopy and intubation of the trachea in a patient receiving nifedipine and verapamil [14].

Biological context of Laryngoscopy

• Left ventricular ejection fraction (LVEF) and other hemodynamic variables were measured immediately before and during induction of anesthesia (thiopental, N2O/O2, succinylcholine, laryngoscopy + oral intubation, halothane) [15].
• Heart rate (HR) and mean arterial pressure (MAP) were recorded before induction of anaesthesia, just before administration of fentanyl, just before laryngoscopy for intubation, and after intubation [16].
• Fentanyl treatment caused a significant attenuation of the blood pressure and pulse response to laryngoscopy and intubation [17].
• As glycopyrrolate has been reported superior to atropine with respect to reduction of salivation, stability of cardiac rate and rhythm, and recovery, a comparison of these properties of the two drugs and placebo was made in 45 patients undergoing direct laryngoscopy and 45 patients undergoing bronchoscopy, in most cases followed by mediastinoscopy [18].
• To determine the effect of intravenous lidocaine on the intraocular pressure (IOP) response to laryngoscopy and intubation, twenty unpremedicated children, ages one to ten years were studied [19].

Anatomical context of Laryngoscopy

• Vocal cord movement was analysed by laryngoscopy while the patients were awake and also during sleep induced by intravenous diazepam [20].
• This suggests that propranolol even in doses adequate to produce significant slowing of HR in awake patients does not ensure protection against increases in HR and MAP associated with laryngoscopy and intubation of the trachea [21].
• After preparation with a vasoconstrictor, the selected, well-lubricated ETT was advanced blindly into the nasopharynx, and intubation was completed under direct laryngoscopy [22].
• It can be concluded that intranasally administered NTG effectively attenuates the pressor response to laryngoscopy and intubation in patients presenting for coronary artery by-pass surgery and that it is more effective and convenient method than intravenous lignocaine [23].
• In two patients, one with Klippel-Feil syndrome and one with fibrous dysplasia of the maxilla, no part of the larynx could be visualized by direct laryngoscopy [24].

Associations of Laryngoscopy with chemical compounds

• Effects of aerosolized lidocaine on circulatory responses to laryngoscopy and tracheal intubation [2].
• The effects of clonidine, a centrally acting alpha 2-adrenergic receptor agonist, on depth of fentanyl anesthesia and on cardiovascular response to laryngoscopy and intubation were studied [25].
• The time to laryngoscopy and intubation did not differ significantly between succinylcholine (48 +/- 10 s) and vecuronium 0.4 mg/kg (57 +/- 13 s); however, both were significantly less than than with vecuronium 0.1 and 0.2 mg/kg (P less than 0.005) [26].
• METHODS: In 26 patients, the end-tidal and corresponding arterial isoflurane concentrations needed to suppress eye opening to verbal command and motor response after trapezius squeeze, 50 Hz electric tetanic stimulation, laryngoscopy, skin incision, and tracheal intubation in 50% of all patients were determined [27].
• The pressor response to laryngoscopy was significantly less marked in the esmolol group [28].

Gene context of Laryngoscopy

• Lidocaine is frequently used in the treatment of hemodynamic changes following laryngoscopy and tracheal intubation during general anesthesia, and is metabolized by CYP3A4 and CYP1A2 isoenzymes in the liver [29].
• Maximum expiratory and inspiratory flow-volume (MEFV, MIFV) curves, specific airway conductance (sGaw), and flexible fiberoptic laryngoscopy were examined in 8 pediatric lung transplant recipients with vocal cord paralysis (VCP) [30].
• RESULTS: Difficult laryngoscopy with a midline approach accounted for 6.5% (66 cases) before OELM and 1.97% (20 cases) after OELM [31].
• RESULTS: With blood propofol concentrations increasing from 2 to 7.3 microg/ml, the C(50) of remifentanil decreased from 3.8 ng/ml to 0 ng/ml for laryngoscopy, from 4.4 ng/ml to 1.2 ng/ml for intubation, and from 6.3 ng/ml to 0.4 ng/ml for intraabdominal surgery [32].
• Two cases are presented in which abnormal FDG PET preceded laryngoscopy or computed tomography in detection of tumor recurrences [33].

Analytical, diagnostic and therapeutic context of Laryngoscopy

• The authors conclude that at a similar anesthetic depth, as assessed by the EEG shift into the lower frequency range (0.5-3 Hz), a markedly reduced fentanyl dose effectively prevented the hyperdynamic cardiovascular response to laryngoscopy and intubation in the group of patients premedicated with clonidine [25].
• We conclude that the administration of fentanyl suppresses the hemodynamic responses to endotracheal intubation more than it does to laryngoscopy [34].
• We conducted a randomized, placebo-controlled, and double-blind study to evaluate the efficacy of oral guanabenz, an alpha 2-adrenergic agonist, in attenuating the cardiovascular and catecholamine responses to laryngoscopy and tracheal intubation in 30 normotensive (ASA physical status 1) patients undergoing elective surgery [35].
• Oral administration of guanabenz before induction of anesthesia is a simple and effective method for attenuating the pressor and tachycardic responses to laryngoscopy and tracheal intubation with the drug acting at least partly via inhibition of the increases in plasma catecholamines concentrations [35].
• The goal of this study was to determine the propofol blood concentration at which 50% of patients did not respond to stimulation (Cp50) for laryngoscopy, intubation with a laryngoscope, insertion of a slotted oral-pharyngeal airway (Ovassapian airway), and intubation with a fiberscope when administered in conjunction with fentanyl [36].

References