 | |  | |  | |  | |  | |  | |  | |  |
| IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711 |
Int J Clin Exp Med 2013;6(9):809-813
Original Article
Effect of laryngoscopy on middle ear pressure during anaesthesia induction
Semih Degerli, Baran Acar, Mehmet Sahap, Eyup Horasanlı
Anaesthesiology Reanimation Clinic, ENT Clinic, Kecioren Training and Research Hospital, Ankara, Turkey
Received August 14, 2013; Accepted September 16, 2013; Epub September 25, 2013; Published September 30, 2013
Abstract: Aims: The procedure of laryngoscopic orotracheal intubation (LOTI) has many impacts on several parts of the body. But its
effect on middle ear pressure (MEP) is not known well. The purpose of this study is to evaluate the MEP changes subsequent to
insertion of endotracheal tube with laryngoscope. Subjects and methods: 44 patients were included in this study with a normal physical
examination of ear, nose and throat. A standard general anaesthesia induction without any inhaler agent was performed to the all
patients. The MEP measurements for both ears were applied under 1 minute; before induction (BI) and after intubation (AI) with a
middle ear analyzer. Also hemodynamic parameters were recorded before induction and after intubation. Results: Of the 44 patients
were 25 women and 19 men with a 43.5±15.1 mean age. A statistically significant rise in MEP was seen in all patients subsequent to
insertion of endotracheal tube (P<0.05). Mean right MEPs were BI: -9.5 and AI: 18.5 daPa. Also mean left MEPs were BI: -21.7 and AI:
29.1 daPa. The amount of increases in left and right MEPs were 50 daPa and 27 daPa, respectively. 20% increase in systolic blood
pressure and 19% increase in diastolic blood pressure were determined after intubation. The mean heart rate was 76/min before
intubation, whereas it was 102/min after intubation with a 34% increase. Conclusion: In this study bilateral significant increases in MEP
were determined subsequent to LOTI. Possible factors affecting MEP may be auditory tube, size and type of the blades, drugs and face
masking time. But on the other hand in our opinion cardiovascular and haemodynamic response to LOTI has the most impact over the
middle ear mucosa with mucosal venous congestion. (IJCEM1308016).
Keywords: Middle ear pressure, laryngoscopy, intubation, endotracheal tube, adult
Address correspondence to: Dr. Semih Degerli, Anaesthesiology Reanimation Clinic, Kecioren Training and Research Hospital,
Sanatoryum C. Ardahan S. No: 25 Kecioren 06380, Ankara, Turkey. Tel: +90 312 356 90 00; Fax: +90 312 356 90 03; E-mail:
drsemih@gmail.com
Original Article
Effect of laryngoscopy on middle ear pressure during anaesthesia induction
Semih Degerli, Baran Acar, Mehmet Sahap, Eyup Horasanlı
Anaesthesiology Reanimation Clinic, ENT Clinic, Kecioren Training and Research Hospital, Ankara, Turkey
Received August 14, 2013; Accepted September 16, 2013; Epub September 25, 2013; Published September 30, 2013
Abstract: Aims: The procedure of laryngoscopic orotracheal intubation (LOTI) has many impacts on several parts of the body. But its
effect on middle ear pressure (MEP) is not known well. The purpose of this study is to evaluate the MEP changes subsequent to
insertion of endotracheal tube with laryngoscope. Subjects and methods: 44 patients were included in this study with a normal physical
examination of ear, nose and throat. A standard general anaesthesia induction without any inhaler agent was performed to the all
patients. The MEP measurements for both ears were applied under 1 minute; before induction (BI) and after intubation (AI) with a
middle ear analyzer. Also hemodynamic parameters were recorded before induction and after intubation. Results: Of the 44 patients
were 25 women and 19 men with a 43.5±15.1 mean age. A statistically significant rise in MEP was seen in all patients subsequent to
insertion of endotracheal tube (P<0.05). Mean right MEPs were BI: -9.5 and AI: 18.5 daPa. Also mean left MEPs were BI: -21.7 and AI:
29.1 daPa. The amount of increases in left and right MEPs were 50 daPa and 27 daPa, respectively. 20% increase in systolic blood
pressure and 19% increase in diastolic blood pressure were determined after intubation. The mean heart rate was 76/min before
intubation, whereas it was 102/min after intubation with a 34% increase. Conclusion: In this study bilateral significant increases in MEP
were determined subsequent to LOTI. Possible factors affecting MEP may be auditory tube, size and type of the blades, drugs and face
masking time. But on the other hand in our opinion cardiovascular and haemodynamic response to LOTI has the most impact over the
middle ear mucosa with mucosal venous congestion. (IJCEM1308016).
Keywords: Middle ear pressure, laryngoscopy, intubation, endotracheal tube, adult
Address correspondence to: Dr. Semih Degerli, Anaesthesiology Reanimation Clinic, Kecioren Training and Research Hospital,
Sanatoryum C. Ardahan S. No: 25 Kecioren 06380, Ankara, Turkey. Tel: +90 312 356 90 00; Fax: +90 312 356 90 03; E-mail:
drsemih@gmail.com
