Summary:
Background: The effects of ProSeal laryngeal mask airway
(PLMA) removal and tracheal extubationon cardiovascular
responses were studied in elderly hypertensive diabetic
patients in a randomize double-blind study.
Methods: A total of 60 elderly controlled diabetic
hypertensive American Society of Anesthesiologists II &
III patients were randomly allocated to two groups (n-30
of each) for PLMA insertion or endotracheal intubation. A
standardized anesthetic sequence was used for induction
and maintenance of anesthesia. The two groups were then
compared for haemodynamic changes at the time of
extubation/PLMA removal.
Results: In PLMA group, heart rate increased during
PLMA removal but remained elevated for only 3 minutes
while mean arterial pressure remained elevated for only 2
minutes.The elevations of heart rate and mean arterial
pressure were exaggerated in the extubation group and
persisted for more than 5 minutes. No complication was
observed in any patient and no difficulty was encountered
in insertion of PLMA in any patient.
Conclusion: Elderly hypertensive diabetic patients are at
risk of exaggerated pressor response at the time of
extubation. PLMA removal is associated with fewer
hemodynamic changes than tracheal extubation and should
be preferred wherever possible.
Key word: Proseal laryngeal mask airway, laparoscopic
surgery, hypertensive type-2 diabetic patient,
(J Bangladesh Coll Phys Surg 2018; 36: 153-158)
DOI: http://dx.doi.org/10.3329/jbcps.v36i4.36087