[Effects of intubating laryngeal mask airway in prevention of extubation responses in patients with hypertensive cerebral hemorrhage during general anesthesia recovery period].
OBJECTIVE
To evaluate the effects of intubating laryngeal mask airway (ILMA) in prediction of extubation responses in patients with hypertensive cerebral hemorrhage during general anesthesia recovery period.


METHODS
A total of 120 patients with hypertensive cerebral hemorrhage aged 47-71 years, with Glasgow Coma Scale (GCS)11-15 scores and American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, undergoing craniotomy surgery from December 2012 to December 2014 in the Affiliated First Municipal Hospital of Fujian Medical University were randomly divided into 2 groups (n=60): tracheal intubation (Group T) and intubating laryngeal mask airway (Group I), by using a random number table. Variations of invasive arterial blood pressure and responses of endotracheal extubation were compared between two groups before and after extubation.


RESULTS
There were no significant differences in ages, sex ratio, preoperative GCS, operation time and the time from the end of operation to Train of Four stimulation (TOF) becoming to 4 between the two groups. The mean arterial pressure (MAP) at the time point of extubation (T3), 1 min (T4), 3 min (T5), 5 min (T6) after extubation were (136±20), (130±16), (128±12), (125±10) mmHg in Group T, and heart rate(HR) at these four time points were (105±11), (96±8), (92±7), (86±6) bpm, respectively. While in group I, MAP were (108±10), (106±8), (105±9), (106±7) mmHg, and HR were (75±8), (76±7), (68±5), (67±6) bpm, respectively. MAP and HR of the two groups at these four time points had significant differences (T3: t=10.91, 17.20; T4: t=13.72, 14.69; T5: t=12.54, 13.35; T6: t=13.39, 11.27; all P<0.01). During recovery, the incidences of extubation responses of group T and group I were 92% and 2%, respectively, and the difference had statistically significant (χ(2)=94.05, P<0.01). The incidences of coughing of group T and group I were 97% and 0, respectively, and the difference had statistically significant (χ(2)=148.69, P<0.01).


CONCLUSIONS
Compared with tracheal intubation, ILMA can decrease the incidence of extubation responses and coughing in patients with hypertensive cerebral hemorrhage during general anesthesia recovery period, and avoid cere-brovascular accidents.
Department of Anesthesiology, Affiliated First Municipal Hospital, Fujian Medical University, Quanzhou 362000, China; #Department of Anesthesiology, Fujian Province Quanzhou Municipal Children Hospital & Women Healthcare Hospital, Quanzhou 362000, China.
J Y
JY
Zeng
S Y
SY
Li
W B
WB
Zhuang
Y Y
YY
Li
Y L
YL
Chen
S Y
SY
Li
D060666:Airway Extubation; D000762:Anesthesia Recovery Period; D001794:Blood Pressure; D003371:Cough; D006339:Heart Rate; D006801:Humans; D020299:Intracranial Hemorrhage, Hypertensive / Q000503:physiopathology*; D007442:Intubation, Intratracheal / Q000379:methods*; D017214:Laryngeal Masks