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Cardiovascular responses to tracheal extubation or LMA removal in children
1Department of Anaesthesiology, University of Tsukuba Institute of Clinical Medicine, Ibaraki, Japan.
Insights
Laryngeal mask airway (LMA) removal caused fewer cardiovascular changes than tracheal extubation in children. This finding suggests LMA removal is a gentler option for pediatric patients post-surgery.
Area of Science:
- Pediatric Anesthesiology
- Cardiovascular Physiology
- Airway Management
Background:
- Tracheal extubation and laryngeal mask airway (LMA) removal are common procedures following pediatric surgery.
- Understanding the cardiovascular responses to these airway management techniques is crucial for patient safety.
Purpose of the Study:
- To compare the cardiovascular effects of laryngeal mask airway removal versus tracheal extubation in pediatric patients.
- To evaluate hemodynamic stability following airway device removal in children undergoing minor elective surgery.
Main Methods:
- A randomized controlled trial involving 60 pediatric patients (4-10 years) undergoing minor elective surgery.
- Patients were allocated to either endotracheal intubation (Group ET) or LMA (Group LMA).
- Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured before and up to 10 minutes after extubation or LMA removal.
Main Results:
- Maximal changes in HR, SBP, and DBP were significantly lower in the LMA group compared to the ET group (median values: HR 12 vs 26, SBP 14 vs 28, DBP 9 vs 13).
- These differences indicate a less pronounced hemodynamic response with LMA removal.
Conclusions:
- Laryngeal mask airway removal results in less significant hemodynamic changes than tracheal extubation in pediatric patients.
- LMA may be a preferable airway management strategy for minimizing cardiovascular stress during emergence from anesthesia in children.
Purpose:
This study was designed to investigate the cardiovascular effects related to tracheal extubation or laryngeal mask airway (LMA) removal in children.
Methods:
Sixty children, ASA physical status 1, 4-10 yr of age, undergoing minor elective surgery (inguinal hernia and phimosis) were allocated randomly to have their surgery performed with endotracheal intubation (Group ET, n = 30) or LMA (Group LMA, n = 30) and were studied for cardiovascular responses related to extubation or LMA removal. Changes in heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured before and 1, 2, 3, 5, and 10 min after tracheal extubation or LMA removal when the patients were awake.
Results:
The maximal changes in HR, SBP and DBP were less in Group LMA than in Group ET during the observation period (HR; 12 vs 26, SBP; 14 vs 28, DBP; 9 vs 13, median, P < 0.05).
Conclusion:
Laryngeal mask airway removal elicited less haemodynamic change than tracheal extubation in paediatric patients.