[Bi-level positive airway pressure ventilation for post-extubation respiratory support under deep anesthesia in...

To evaluate the effect of bi-level positive airway pressure ventilation (BiPAP) for post-extubation respiratory support under deep anesthesia in hypertension patients.

Forty primary hypertension patients who were scheduled for lower abdominal surgery or total hip joint replacement were randomly divided into 2 groups: one was extubated when being awake (Group A, n = 20, and the other was extubated under deep anesthesia (Group B, n = 20). The combined inhalation and the intravenous general anesthesia were performed on all patients, and inhalation anesthesia was maintained with only continued infusion of propofol when major procedure of surgery had been finished. In Group A, anesthesia was ceased when the surgery was finished, and trachea was removed after the patients awoke. In Group B, anesthesia was ceased immediately before the extubation, and trachea was removed under deep anesthesia, followed by an uninvasive ventilation of BiPAP. Blood pressure (BP, heart rate ( HR, and bispectral index (BIS) before or after the extubation, artery blood-gass analysis in BIPAP, and the incidence rate of complication in the recovery period were recorded.

In Group A, BP and HR increased significantly after the patients awoke (P < 0.01) and after the extubation (P < 0.05), compared with the data before the surgery and before the extubation. In Group B, however, BP and HR had no difference before and after the extubation, and the data of blood gas maintained approximately normal. The incidence rate of glos- soptosis in Group B was obviously higher than those in Group A (P < 0.01), while complications such as cough during the recovery stage in Group A were more than those in Group B (P <0.05).

BiPAP is suitable for post-extubation respiratory support under deep anesthesia in hypertension patients.