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Cardiovascular and plasma catecholamine responses at tracheal extubation
A Lowrie1, P L Johnston, D Fell
1University Department of Anaesthesia, Leicester Royal Infirmary.
British Journal of Anaesthesia
|March 1, 1992
Summary
Tracheal intubation significantly increased heart rate, blood pressure, and stress hormones. Extubation caused only minor increases in heart rate and adrenaline levels, suggesting a less stressful emergence from anesthesia.
Area of Science:
- Anesthesiology
- Cardiovascular Physiology
- Surgical Recovery
Background:
- Tracheal intubation and extubation are common procedures during anesthesia.
- Hemodynamic responses and stress hormone release during these events are clinically significant.
- Understanding these responses aids in optimizing patient care and recovery.
Purpose of the Study:
- To compare hemodynamic and neuroendocrine responses to tracheal extubation versus intubation.
- To evaluate the stress associated with emergence from anesthesia.
- To inform anesthetic management strategies.
Main Methods:
- 12 patients undergoing major elective surgery were studied.
- Hemodynamic parameters (heart rate, systolic/diastolic arterial pressure, rate-pressure product) were measured.
- Plasma adrenaline and noradrenaline levels were quantified at various time points.
Main Results:
- Tracheal intubation significantly increased heart rate, blood pressure, rate-pressure product, and catecholamine levels.
- Tracheal extubation resulted in only significant increases in heart rate and adrenaline at 5 minutes post-procedure.
- Laryngoscopy was avoided during extubation to minimize stimulation.
Conclusions:
- Tracheal intubation provokes a more pronounced stress response than tracheal extubation.
- Anesthesia emergence, particularly without laryngoscopy, is hemodynamically and neuroendocrinologically less taxing.
- These findings support strategies for smoother patient recovery post-surgery.