Key result
Laryngeal mask airway removal provided significantly greater hemodynamic stability, with a lower mean arterial pressure (92.16 vs 113.04 mmHg) just after extubation compared to endotracheal extubation.
Why the study?
The study aimed to evaluate and compare hemodynamic responses following endotracheal tube extubation versus laryngeal mask airway removal in ASA I and II patients undergoing short surgical procedures.
Does laryngeal mask airway removal improve hemodynamic stability compared to endotracheal tube extubation in patients undergoing short surgical procedures?
RCT (n=100)
Double-blind
Computer-based randomization by systematic random sampling using computer generated code
No
Does laryngeal mask airway removal improve hemodynamic stability compared to endotracheal tube extubation in patients undergoing short surgical procedures?
Absolute Event Rate: 92.16% vs 113.04%
p-value: p=<0.0001
Laryngeal mask airway removal provides better hemodynamic stability and fewer respiratory complications compared to endotracheal extubation in patients undergoing short surgical procedures.
Airway device removal may affect hemodynamics in low-risk patients; observational data leaves open need for confirmatory trials before practice change.
Aims and Objectives: The aim of the study was to evaluate and compare the hemodynamic responses after endotracheal tube (ET) extubation and laryngeal mask airway (LMA) removal in American Society of Anaesthesiologists (ASA) I and ASA II patients undergoing short surgical procedures. Methods: This was a randomized, comparative, observational, and clinical study conducted in a tertiary care medical college. The duration of study was 1 year. Hundred patients of ASA Grade I and II with age between 18 and 60 years, including both males and females posted for short surgeries under general anesthesia were selected for the study. Patients were divided into two groups (Depending on whether endotracheal intubation was done or LMA was used) of 50 patients each. Hemodynamic parameters (systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial pressure [MAP], and heart rate [HR]) were recorded and compared before induction, during surgery and postoperatively at 1, 2, 5, and 10 min between both the groups. Results: There was no significant difference between these two groups regarding the demographic aspect of the patients such as age and gender. Furthermore, the parameters such as ASA grade and duration of surgery were comparable. The baseline hemodynamic parameters between the two groups were also similar and no significant difference was observed. The changes in hemodynamics (mean HR, SBP, DBP, and MAP) were more in Group E as compared to Group L and the difference was found to be statistically significant (p<0.05). Similarly respiratory events were more profound in Group E as compared to Group L and the difference was found to be statistically significant (p<0.05). Conclusion: LMA is a better choice for short surgical procedures as it provides more hemodynamic stability during removal as compared to ET extubation. LMA is also associated with less complications as compared to ET.
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PHAPHAGIRE et al. (2023) conducted an RCT in Patients undergoing short surgical procedures under general anesthesia (n=100). Laryngeal mask airway (LMA) vs. Endotracheal tube (ET) was evaluated on Mean arterial pressure just after extubation (mmHg) (p=<0.0001). Laryngeal mask airway removal provided significantly greater hemodynamic stability, with a lower mean arterial pressure (92.16 vs 113.04 mmHg) just after extubation compared to endotracheal extubation.
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