The influence of cigarette smoking on the cardiovascular response to direct laryngoscopy and endotracheal intubation

Aim: To determin if cigarette smoking influences the cardiovascular response to direct laryngoscopy and endotracheal intubation under general anaesthesia. Method: This was a prospective study of haemodynamic changes in response to tracheal intubation in 50 ASA 1 (ASA = American Society of Anesthesiologists) men undergoing elective general or urological surgery under general anaesthesia with endotracheal intubation. Twenty-five of the men were smokers of more than 10 cigarettes a day, while the other 25 were non-smokers. Anaesthesia was induced with thiopental and endotracheal intubation facilitated with atracurium. Measurements of systolic, diastolic and mean arterial pressures, heart rate and oxygen saturation were recorded at intubation, 45 seconds after intubation and at 30-second intervals thereafter for a period of 4 minutes. Results: Immediately after intubation, heart rate of smokers [mean: 105.0 (SD17) beats/min] was significantly greater (