Cardiovascular stability during carotid endarterectomy: endotracheal intubation versus laryngeal mask airway

Journal of Clinical Anesthesia
D R MariettaG E Hill

Abstract

To compare cardiovascular stability during carotid endarterectomy in groups managed either with laryngeal mask airway (LMA) or endotracheal intubation. Randomized, retrospective, blinded study. Teaching hospital. 61 ASA physical status II, III, and IV unpremedicated adult males scheduled for carotid endarterectomy. Following standardized anesthetic technique, including intravenous (i.v.) induction with thiopental sodium 3 to 4 mg/kg, fentanyl 2 to 3 microg/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. 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 ...Continue Reading

References

Aug 15, 1991·The New England Journal of Medicine·UNKNOWN North American Symptomatic Carotid Endarterectomy Trial CollaboratorsM Eliasziw
Nov 9, 1989·The New England Journal of Medicine·K E RabyA P Selwyn
Dec 28, 1995·The New England Journal of Medicine·D T Mangano, L Goldman
Apr 1, 1994·Anesthesiology·E I Eger
Mar 1, 1994·Anesthesiology·J H DevittM P O'Donnell
Aug 1, 1996·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·B F SpiekermannT A Yemen

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Citations

Feb 21, 2008·Der Anaesthesist·T RösselT Koch
Jan 6, 2005·International Anesthesiology Clinics·Rae AllainGeetha Jeyabalan
Oct 4, 2006·Current Opinion in Anaesthesiology·C Verghese

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