Study Of The Interrelationship Between The Strese Response Of Laryngoscopy And Tracheal Intubation And ABO Blood Group

Objective: Numerous data indicated that the stress response and the level of internal secretion differed in different ABO blood group. Stress response was completely indispensable to virus infection digestive canker coronary heart disease neural system disease and tumour etc. Many diseases were relevant to ABO blood group. Laryngoscopy and Tracheal Intubation induced stress response of the body and induced hypertension arrhythmia indeed sudden death. Many investigations were performed to find some medicines and methods to decrease stress response. Up to now, no data indicate that there is significance between ABO blood group and intubation stress response. This study is toinvestigate the interrelationship between the two.Method: Two hundred and six patients during June to December in 2004, ASA I - II ,excluded circulative and endocrinic system disease scheduled for elective surgery under general anesthesia with tracheal intubation were divided into four groups: A group(n=70), B group(n=64), O group(n=56) and AB group(n=16). Anesthesia of the four groups was induced with fentany 5 μ g/kg, midazolam 0.1 mg/kg and vecuronium 0.1 mg/kg. Laryngoscopy and Tracheal Intubation was successfully performed within 30 seconds. Mechanical ventilation was started and SBP MAP HR and SPO2 were continuously monitored with HP 78354 made in America. SPO2 was maintained at 98% or more higher before and after intubation. Observe the changes of SBP DBP MAP HR at the time before induction before intubation and one minute after intubation and wrote them down. Calculated the differences of HR SBP MAP before and after intubation. Six patients out of each group were taken blood samples from peripheral vein(3ml) at the time before intubation one minute after intubation five minutes after intubation. The plasma concentration of angiotonin angiotensin- II and aldsterone were determined. Data were expressed as means ±SE. Data were analyzed with the computer statistical program SPSS 10.0 for windows.Results:1. There was no significant difference in age body weight and bloodgroup among the four groups(p>0.05).2. Changes of blood pressure and heart rate of the four groups:(1) There was no significant difference in HR SBP MAP and ABO blood group before induction among the four groups (p>0.05).(2 ) Differences of HR before and after intubation: A group 16.75 ± 4.69, B group 14.18 + 3.40,0 group 9.25 + 2.41 and AB group 10.36 + 3.16.There was significant difference among ABO blood group. The difference in A group was the most significant(p<0.001) and the difference in O group was the lest significant(p<0.05).Significant difference exsisted in O group and A group(p<0.05).(3 ) Differences of SBP before and after intubation: A group 4.28 + 0.18, B group 4.65 + 0.56, O group 2.94 + 0.11 and AB group 3.14 + 0.20. There was significant difference among ABO blood group. The difference in A group was the most significant(p<0.001) and the difference in O group was the lest signiflcant(p<0.05). Significant difference exsisted in O group and A group(p<0.05).(4) Differences of MAP before and after intubation: A group2.61 + 0.41,B group2.49 + 0.36, O group 1.66+ 0.28 and AB group 1.94+ 0.93. The was significant difference among ABO blood group. The difference in A group was the most significant(p<0.001)and the difference in O group was the lest significant(p<0.05).Significant difference exsisted in O group and A group(p<0.05).3. Changes of plasma concentration of angiotonin angiotensin- II and aldsterone: There was no significant difference in the plasma concentration ofangiotonon> angiotensin and aldsterone before intubation. The plasma concentration increased one minute and five minute after intubation when compared before intubation. The difference in A group was the most significant(p<0.001)and the difference in O group was the lest significant(p<0.05).Significant difference exsisted in O group and A group(p<0.05).Conclusion: The stress response of Laryngoscopy and Tracheal Intubation still exsisted when intravenous anesthesia induced with fentany 5 u g/kg, midazolam O.lmg/kg and vecuronium O.lmg/kg. There was significant difference among ABO blood group. The response in A group is the strongest and the slightest in O group. A group and O group differentiated clearly when contrasted.