Comparative Study of Pressor Responses after Tracheal Extubation and LMA (Laryngeal Mask Airway) Removal in Controlled Hypertensive Patients: A Randomised Clinical Trial
Journal Title: International Journal of Health Sciences and Research - Year 2017, Vol 7, Issue 3
Abstract
Background and objectives: Airway management using endotracheal intubation and laryngeal mask airway (LMA) are known to induce hemodynamic changes. The predominant response is tachycardia and systemic hypertension. The present study was undertaken to compare the hemodynamic responses after tracheal extubation and LMA removal in controlled hypertensive patients. Methodology: The study was conducted on 70 patients in age group of 35-65 yrs, ASA Grade II scheduled for elective surgical procedures. Patients were allocated in randomized manner in two groups, one undergoing endotracheal tube intubation (Group T) and other undergoing laryngeal mask airway insertion (Group L). Each group had 35 patients. The hemodynamic data included pulse rate and blood pressure that were recorded at time intervals: baseline before intubation, at 1, 2, 3, 5 and 10 min after extubation or LMA removal. Rate pressure product was calculated. Results: Extubation caused significant increase in mean pulse rate in Group T, which failed to reach baseline level after 10 minutes. LMA removal in Group L was associated with significant increase in mean pulse rate however it returned back to baseline at 5minutes after removal. Significant rise in MAP after extubation and LMA removal was observed in Group T and L, it did return to baseline values after 5 min in Group L and no such effect observed even after 10 min in Group T. Rise in mean pulse rate and mean arterial pressure was significantly higher when compared between group T and group L. Similar observations were made for rate pressure product in Group L and T respectively. Interpretation and conclusion: Both endotracheal extubation and laryngeal mask airway removal were associated with a statistically significant rise in pulse rate, rate pressure product and MAP. The rise was significantly higher in Group T as compared to Group L. LMA removal was found to be accompanied with lesser pressor response as compared to endotracheal tube extubation in controlled hypertensive patients. Use of Laryngeal mask airway is quite advantageous and hence is desirable in hypertensive patients.
Authors and Affiliations
Dr Basheer Ahmed Khan
Keywords
Related Articles
- EP ID EP368683
- DOI -
- Views 128
- Downloads 0
Determinants of Midwifery Practice in the Active Management of Third Stage of Labor in Omdurman State, Sudan
Background: Active management of the third phase of labor (AMTSL) has been shown to lessen blood loss in women undergoing vaginal childbirth. It could avert maternal deaths and morbidity. Objective: To assess the Knowled...
Pulmonary Renal Syndrome: Update Article
The pulmonary–renal syndrome (PRS) refers to the combination of diffuse alveolar haemorrhage and rapidly progressive glomerulonephritis (RPGN). Pulmonary-renal syndrome can originate from various systemic autoimmune dise...
Hand Hygiene, Attitude and Barriers among Health Care Workers at a Tertiary Care Teaching Hospital, Uttarakhand
Introduction: Health care associated infection (HCAI) is one of the most significant, and current phenomena for discussions in health care industry. Hand hygiene was thought to be a key factor in reducing hospital acquir...
Effect of Oral Chelation Therapy on Physical Growth and Serum Ferritin Levels in Children with Thalassemia Major in Tertiary Care Hospital in Western Maharashtra
Objectives: To study the effects of oral iron chelation regimen on serum ferritin levels, the physical and sexual growth of children with thalassemia major Methods:-This is prospective study of total 42 Children of thal...
Oral Health Knowledge, Attitude and Practice and Its Relation to Oral Health Status among 12-Year Old School Children of Sullia Taluk
Introduction: Good oral health practices are necessary from an young age to ensure positive long term dental health and hygiene and the oral health of children is important towards their overall well being. Objectives: T...