TY - JOUR
T1 - Cardiovascular stability during carotid endarterectomy
T2 - Endotracheal intubation versus laryngeal mask airway
AU - Marietta, Dean R.
AU - Lunn, Judd K.
AU - Ruby, Elizabeth I.
AU - Hill, Gary E.
PY - 1998/2/1
Y1 - 1998/2/1
N2 - Study Objective: To compare cardiovascular stability during carotid endarterectomy in groups managed either with laryngeal mask airway (LMA) or endotracheal intubation. Design: Randomized, retrospective, blinded study. Setting: Teaching hospital. Patients: 61 ASA physical status II, III, and IV unpremedicated adult males scheduled for carotid endarterectomy. Interventions: Following standardized anesthetic technique, including intravenous (IV) induction with thiopental sodium 3 to 4 mg/kg, fentanyl 2 to 3 μg/kg), and isoflurane, standard intraoperative cardiovascular monitoring plus direct arterial blood pressure measurements were instituted. Patients were randomly assigned to an endotracheal intubation or LMA group. Measurements and Main Results: Distinct intraoperative episodes of ±25% increase or decrease of mean arterial blood pressure (MABP) and heart rate (HR) when compared with preinduction baseline values, and the number of such episodes requiring interventional therapy were recorded from a blinded anesthesia record retrospectively. Mean end- tidal isoflurane determination and total case duration enabled calculation of minimum alveolar concentration (MAC) hours of isoflurane administered. The LMA group had a significantly (p < 0.05) lower incidence of increased MABP and HR episodes and such episodes requiring drug therapy than did the endotracheal intubation group. No difference was found in the length of surgery, mean end-tidal isoflurane concentration, or the total number of MAC hours of isoflurane administered. Conclusions: During carotid endarterectomy, a reduced incidence of hypertensive and tachycardic episodes, as well as such episodes requiring interventional drug therapy, was found in the group whose airway is managed by LMA when compared with endotracheal intubation.
AB - Study Objective: To compare cardiovascular stability during carotid endarterectomy in groups managed either with laryngeal mask airway (LMA) or endotracheal intubation. Design: Randomized, retrospective, blinded study. Setting: Teaching hospital. Patients: 61 ASA physical status II, III, and IV unpremedicated adult males scheduled for carotid endarterectomy. Interventions: Following standardized anesthetic technique, including intravenous (IV) induction with thiopental sodium 3 to 4 mg/kg, fentanyl 2 to 3 μg/kg), and isoflurane, standard intraoperative cardiovascular monitoring plus direct arterial blood pressure measurements were instituted. Patients were randomly assigned to an endotracheal intubation or LMA group. Measurements and Main Results: Distinct intraoperative episodes of ±25% increase or decrease of mean arterial blood pressure (MABP) and heart rate (HR) when compared with preinduction baseline values, and the number of such episodes requiring interventional therapy were recorded from a blinded anesthesia record retrospectively. Mean end- tidal isoflurane determination and total case duration enabled calculation of minimum alveolar concentration (MAC) hours of isoflurane administered. The LMA group had a significantly (p < 0.05) lower incidence of increased MABP and HR episodes and such episodes requiring drug therapy than did the endotracheal intubation group. No difference was found in the length of surgery, mean end-tidal isoflurane concentration, or the total number of MAC hours of isoflurane administered. Conclusions: During carotid endarterectomy, a reduced incidence of hypertensive and tachycardic episodes, as well as such episodes requiring interventional drug therapy, was found in the group whose airway is managed by LMA when compared with endotracheal intubation.
KW - Anesthetic requirements
KW - Cardiovascular parameters
KW - Carotid endarterectomy
KW - Intubation, endotracheal
KW - Laryngeal mask airway
UR - http://www.scopus.com/inward/record.url?scp=0032005503&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032005503&partnerID=8YFLogxK
U2 - 10.1016/S0952-8180(97)00221-3
DO - 10.1016/S0952-8180(97)00221-3
M3 - Article
C2 - 9526939
AN - SCOPUS:0032005503
SN - 0952-8180
VL - 10
SP - 54
EP - 57
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
IS - 1
ER -