The effect of aging on the hemodynamic response to endotracheal intubation during the induction of anesthesia

Abstract

Background: The aim of this study was to evaluate the effect of aging on the hemodynamic response to endotracheal intubation during the induction of anesthesia. Methods: Fifty patients with American Society of Anesthesiologists physical status classification 1 or 2 were enrolled and allocated according to age to either group N (35-44 years, not elderly, n=25) or group E (65-74 years, elderly, n=25). The patients were administered 3 minimum alveolar concentrations of sevoflurane for 5 minutes for the induction of anesthesia. Systolic arterial pressure (SAP) and heart rate (HR) were recorded before (baseline), immediately after (T0), and at 1-minute intervals during the first 4 minutes after endotracheal intubation (T1-T4). Results: SAP increased by 15.4% and 10.8% (p<0.05) from the baseline at T0 and T1, respectively, in group N, and by 21.6%, 17.8%, and 11.8% (p<0.05) from the baseline at T0, T1 and T2 respectively, in group E. The SAP increases at T0, T1 and T2 were significantly greater in group E than in group N (p<0.05). The HR increases at T0 and T1 were significantly greater for group N than for group E (p<0.05). Conclusion: We recommend that anesthesiologists vigilantly monitor and attenuate adverse hemodynamic responses for at least 5 minutes after endotracheal intubation especially in elderly patients, particularly because significant systolic hypertension can occur in this age group.