[The application of nasopharyngeal airway in nurosurgery patients during anesthesia recovery].
OBJECTIVE
To evaluate safety and effectiveness of nasopharyngeal airway used for neurosurgery patients during the anesthesia recovery period.


METHODS
A total of 60 patients (ASAI-II), aged between 25 to 67 years old, who were scheduled to undergo elective neurosurgery operation under general anesthesia, were randomly divided into the oropharyngeal airway group (group O) and the nasopharyngeal airway group (group N), with 30 cases in each group. After respiratory recovery was satisfactory at the end of operation, endotracheal tube was extubated under deep anesthesia. Afterwards, oropharyngeal airway was intubated in group O, and nasopharyngeal airway was intubated in group N. BP and HR before induction (T0), before airway intubation (T1), at 1 min (T2) and 5 min (T3) after airway intubation were recorded. Meanwhile, one-time success rate of airway intubation, the airway retention time, the times of airway regulation due to location change and the change of respiration and circulation in each groups during airway retention period were recorded. In addition, adverse reactions during airway retention period and tolerance scores of patients in both groups were recorded.


RESULTS
BP and HR in group N at T1 and T2 increased significantly compared with T0 (P < 0.05), Compared with T1, BP and HR increased significantly at T2 in group N (P < 0.05). Compared with T1 and T2, the same index reduced significantly at T3 (P < 0.05). BP and HR in group N were significantly higher than those in group O at T2 (P < 0.05). Airway retention time in group N was significantly longer than that in group O [(137.4 +/- 18.32) min vs. (64.2 +/- 8.25) min, P < 0.053; the times of airway location regulation in group N was less than that in group O (0.34 +/- 0.21 vs. 2.80 +/- 0.54) (P < 0.05). During airway retention period the incidence of BP and HR exceeding the base value by 15% in group O was higher than that in group N (80.0% vs. 46.7%)(P < 0.01), and the incidence of SPO2 less than 95% in group O was higher than that in group N (26.7% vs. 6.7%) (P < 0.05). The incidence of nausea, upper airway obstruction and restlessness in group O was significantly higher than that in group N (P < 0.05). Moreover, airway tolerance score of patients in group N was significantly better than that in group O (P < 0.05).


CONCLUSIONS
Nasopharyngeal airway could better maintain unobstructed upper airway in neurosurgery patients during the anesthesia recovery period with advantages such as small circulatory effect, good tolerance and fewer complications.
Department of Anesthesology, West China Second Hospital, Sichuan University; Key Laboratory of Obstetric Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu 610041, China.
Lin-Li
LL
Luo
Liang-Xue
LX
Zhou
Li-Jun
LJ
Chen
Sheng
S
Lü
Wei
W
Huang
Dong
D
Luo
D000328:Adult; D000368:Aged; D058109:Airway Management / Q000295:instrumentation / Q000379:methods*; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx