Proseal Laryngeal Mask Airway or Endotracheal Tube for Emergence From Neuroanesthesia

Ricard Valero

Status: Completed

Conditions: Hypertension on Emergence

Treatments: Procedure: Endotracheal tube; Procedure: LMA

Study type: Interventional

Funder types: Other

Identifiers

NCT01718470

LMAvsETT

Details and patient eligibility

About

Extubation and emergence from anesthesia lead to systemic and cerebral hemodynamic changes that can cause cerebral edema and hemorrhage. The hemodynamic profile on emergence is more favorable if a laryngeal mask airway (LMA) is inserted before neurosurgical patients emerge from anesthesia. We aimed to compare the impact of awakening neurosurgery patients after insertion of a ProSeal LMA to replace the endotracheal tube (ETT).

Full description

At the end of surgery, the anesthesiologist opened a sealed envelope labeled with software-generated randomized numbers to learn the patient's assignment to one of two groups to emerge from anesthesia with the ETT still in place or after it had been replaced by an LMA.

Hemodynamic variables were recorded at 8 moments: baseline, in the operating room one minute before anesthetic induction; 5 minutes after the end of surgery before awakening (ETT group) or before tube replacement (LMA group); and 1, 5, 10, 15, 30 and 60 min after extubation or LMA removal (according to group assignment).

Enrollment: 42 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Elective craniotomy

Exclusion criteria

• Difficult airway
• Uncontrolled hypertension before surgery
• gastroesophageal reflux

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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42 participants in 2 patient groups

Endotracheal tube

Active Comparator group

Description:

At the end of surgery, emerge from anesthesia with the ETT still in place

Treatment:

Procedure: Endotracheal tube

Laryngeal mask

Active Comparator group

Description:

At the end of surgery,emerge from anesthesia after ETT had been replaced by an LMA.

Treatment:

Procedure: LMA