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We also speculate that the pushing of the DLT down the trachea into one main bronchus creates more stimulus than a single-lumen tube intubation, where the tube ends in the middle of the trachea. However, there are no data regarding the haemodynamic response to DLT intubation with conventional laryngoscopy or with an alternative device. A recently published study focusing on the duration of intubation with the DLT Airtraq? laryngoscope found no superiority of the DLT Airtraq? laryngoscope over the conventional MacIntosh laryngoscope [3]. Our hypothesis was that intubation with the DLT-Airtraq? could provide similar haemodynamic advantages to those shown by Ndoko et al. [1] for single lumen tube intubation, although we were aware that DLT placement significantly differs GDC-0449 chemical structure from single lumen tube intubation. Thus, the aim of our study was to investigate the haemodynamic and catecholamine response at DLT placement with the DLT-Airtraq??laryngoscope compared to DLT placement with the conventional MacIntosh laryngoscope. Methods Before we enrolled patients in our study, we obtained institutional ethics committee approval, registration at EudraCT (Ethics Committee of the Medical University Vienna, Ref.Nr. 549/2008, EudraCT Ref. Nr. 2008-006233-27) and written informed consent. In previous studies with comparable protocols for induction of anaesthesia, systolic arterial blood pressure (SAP) at tracheal intubation was approximately 110 mmHg (20 mmHg SD)[1, 4]. Assuming Quinapyramine a type-1 error of 5% and a 90% chance to detect a difference in SAP at intubation of 20% (22 mmHg) between the groups, 18 patients in each group were required. To keep the statistical power high, we enrolled 20 patients per group to account for a possible drop-out rate of 10%. We included adult patients of ASA class 1-3 undergoing elective surgery with the need for DLT tube placement. Patients taking medication with anti-hypertensive or beta-blocking agents on the day of surgery were excluded because MS-275 purchase this may affect haemodynamic and catecholamine responses. Further exclusion criteria were cardiac arrhythmias and history of previous difficult intubation procedures, as these may inappropriately prolong intubation attempts or require awake fibre-optic intubation. Patients were randomised either to the MacIntosh group or the Airtraq? group. Therefore, group labels were written on a total of 40 cards (20 per group). The cards were put into opaque envelopes, effectively mixed, and put into a box. This was done by a person who was not involved in the study. After entering the operation room, an envelope was picked from the box, opened and the patient was assigned to the indicated group. Patient?s demographic data (ASA-status, age, height, weight, gender) and the Mallampati Score were recorded after informed consent was received. Patients received midazolam 7.5 mg p.o.