Key result
Exchange extubation using LMA Supreme significantly attenuated hemodynamic stress, resulting in a lower heart rate (83.8 vs 92.47, p<0.0001) immediately after extubation compared to traditional ETT.
Why the study?
Patients with arterial hypertension exhibit excessive pressor responses to extubation that can trigger arrhythmias or ischemia, and a standard method to attenuate this response is lacking.
Does exchange extubation using LMA Supreme reduce hemodynamic stress response compared to traditional awake extubation in controlled hypertensive patients?
RCT (n=50)
permuted blocks
No
Does exchange extubation using LMA Supreme reduce hemodynamic stress response compared to traditional awake extubation in controlled hypertensive patients?
Absolute Event Rate: 83.8% vs 92.47%
p-value: p=<0.0001
Exchange extubation using LMA Supreme effectively blunts the hemodynamic stress response compared to traditional awake extubation in controlled hypertensive patients undergoing general anesthesia.
May blunt extubation-related tachycardia in practice; leaves open confirmation via randomized trials.
Background: Anesthesia is quite remarkable and attenuation of pressor response is one of the most keenly researched subjects in the field of anaesthesiology, the reason being the non-availability of a ‘procedure/drug of choice’ for the same. Patients with arterial hypertension generally exhibit excessive pressor response to stress such as laryngoscopy, intubation, surgical incision and extubation, which can lead to arrhythmias, myocardial ischemia and cerebrovascular accidents. Exchange extubation with LMA Supreme can be used to overcome or blunt the excessive pressor response following extubation. Objective: To compare the hemodynamic changes during traditional awake extubation and extubation using LMA supreme in controlled hypertensive patients. Methods: The prospective study was carried out in the department of Anaesthesiology, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from January to December-2021. Fifty (50) patients were randomized by permuted blocks into two groups. After complete pre- anesthetic check-up and investigations. Controlled hypertensive patients with ASA (American Society of Anesthesiologists) grade II, between the age of 17 and 65 years, undergoing elective, non-oral surgery were included in the group. Hemodynamic stress response between traditional awake extubation of the endotracheal tube (ETT) and that following exchange extubation of ETT by using a laryngeal mask airway (LMA Supreme) in terms of Post Extubation Heart Rate (H.R), Systolic Blood Pressure (S.B.P), Diastolic Blood Pressure (D.B.P), Mean Arterial Pressure (MAP), to determine whether this method is easy to perform, the amount of experience needed to perform the exchange well and to calculate the time delay in extubation caused by adopting this method. Results: There was highly significant increase in pulse rate in Group A (ETT Group) as compare to LMA SupremeTM group, which was statistically significant till 15min. of extubation. Statistically ...........
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Anam et al. (2022) conducted an RCT in Controlled hypertension (n=50). Exchange extubation using LMA Supreme vs. Traditional awake extubation of the endotracheal tube (ETT) was evaluated on Heart rate just after extubation (E0) (p=<0.0001). Exchange extubation using LMA Supreme significantly attenuated hemodynamic stress, resulting in a lower heart rate (83.8 vs 92.47, p<0.0001) immediately after extubation compared to traditional ETT.
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