British Journal of Anaesthesia, 1988, Vol. 60, No. 2 167-170
© 1988 The Board of Management and Trustees of the British Journal of Anaesthesia
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ANTERIOR FONTANELLE PRESSURE RESPONSES TO TRACHEAL INTUBATION IN THE AWAKE AND ANAESTHETIZED INFANT
Department of Anaesthesia and the Research Institute, The Hospital for Sick Children, University of Toronto Ontario, Canada.
Correspondence to M. M., Department of Anaesthesia, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.
* Present address: Department of Anaesthetics, John Radcliffe Hospital, Headington, Oxford OX3 9DU.
In order to define the changes in intracranial pressure which occur during tracheal intubation in young infants, a Ladd transducer was used to monitor anterior fontanelle pressure (AFP) non-invasively in awake (group 1, n = 14) and anaesthetized (group 2, n = 10) infants during intubation of the trachea. Heart rate and systolic arterial pressure were also recorded. In quiet, undisturbed infants, AFP (mean±SEM) was similar in groups 1 (9.6±0.5 mm Hg) and 2 (8.7±0.8 mm Hg); with crying, AFP increased significantly in both groups. During laryngoscopy in group 1, AFP increased to 33.5±3.6 mm Hg, which was significantly greater than in the quiet infant, but did not differ significantly from measurements in the crying infant. In group 2, AFP increased significantly to 15.8±18 mm Hg during laryngoscopy. This increase was significantly less than the group 1 response. Neither heart rate nor systolic arterial pressure changed significantly in either group during laryngoscopy—when compared with measurements in the quiet state. It was concluded that AFP increases significantly during intubation and during crying in the infant. The response to intubation is only partially attenuated by the prior administration of general anaesthesia.
Presented in part at the meeting of the Association of Paediatric Anaesthetists of Great Britain and Ireland, held at Leeds in March 1987.
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