I-gel Laryngeal Mask Airway Combined with Tracheal Intubation Attenuate Systemic Stress Response in Patients Undergoing Posterior Fossa Surgery.
BACKGROUND
The adverse events induced by intubation and extubation may cause intracranial hemorrhage and increase of intracranial pressure, especially in posterior fossa surgery patients. In this study, we proposed that I-gel combined with tracheal intubation could reduce the stress response of posterior fossa surgery patients.


METHODS
Sixty-six posterior fossa surgery patients were randomly allocated to receive either tracheal tube intubation (Group TT) or I-gel facilitated endotracheal tube intubation (Group TI). Hemodynamic and respiratory variables, stress and inflammatory response, oxidative stress, anesthesia recovery parameters, and adverse events during emergence were compared.


RESULTS
Mean arterial pressure and heart rate were lower in Group TI during intubation and extubation (P < 0.05 versus Group TT). Respiratory variables including peak airway pressure and end-tidal carbon dioxide tension were similar intraoperative, while plasma β-endorphin, cortisol, interleukin-6, tumor necrosis factor-alpha, malondialdehyde concentrations, and blood glucose were significantly lower in Group TI during emergence relative to Group TT. Postoperative bucking and serious hypertensions were seen in Group TT but not in Group TI.


CONCLUSIONS
Utilization of I-gel combined with endotracheal tube in posterior fossa surgery patients is safe which can yield more stable hemodynamic profile during intubation and emergence and lower inflammatory and oxidative response, leading to uneventful recovery.
Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, No.1 Swan Lake Road, Hefei 230036, China.
Chaoliang
C
Tang
Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, No.1 Swan Lake Road, Hefei 230036, China.
Xiaoqing
X
Chai
Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, No.1 Swan Lake Road, Hefei 230036, China.
Fang
F
Kang
Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, No.1 Swan Lake Road, Hefei 230036, China.
Xiang
X
Huang
Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, No.1 Swan Lake Road, Hefei 230036, China.
Tao
T
Hou
Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, No.1 Swan Lake Road, Hefei 230036, China.
Fei
F
Tang
Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, No.1 Swan Lake Road, Hefei 230036, China.
Juan
J
Li
D000293:Adolescent; D000328:Adult; D003388:Cranial Fossa, Posterior / Q000601:surgery*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D055815:Young Adult; D001615:beta-Endorphin / Q000378:metabolism
C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D001615:beta-Endorphin