Influences of Supreme laryngeal mask airway on tracheal intubation response in total hip replacement for older patients

Abstract:

Objective：To discuss the influence of Supremes laryngeal mask airway（SLMA） and tube intubation on total hip replace－ment for older patients under general anesthesia. Methods：Fifty elderly patients of Ⅰ-Ⅱbased on the grading of American Standards Association（ASA） were received selective radical total hip replacement under general anesthesia and were randomly allocated into two groups：laryngeal mask group（group L，n=25） and tube intubation group（group T，n=25）. Inducting and maintaining methods of general anesthesia were the same and radial puncture was made to monitor continuous systolic blood pressure（SBP），diastolic blood pressure（DBP） and heart rate（HR）. Values of SBP，DBP and HR of two groups were recorded before induction（T0，basic val－ues） and during tracheal intubation（LMA）（T1）and 5 min after tracheal intubation（LMA）（T2） and 15 min after tracheal intubation（LMA）（T3）. At the same time in the above the corresponding points，venous blood was extracted. Plasma concentrations of epinephrine（E） and norepinephrine（NE） were detected using reversed phase ion pair chromatography-electrochemical measurements and con－tent of blood serum cortisol（COR） was determined by radio-immunoassay. Results：There was no significant difference in sex，age and body quality between the two groups（P >0.05）. SBP，DBP and HR were increased significantly during T1 and T2 in group T（P<0.05） with each value significantly higher than those in group L（P<0.05）. There was no significant change in values of SBP，DBP and HR in group L after placing SLMA（P >0.05）. Values of SBP，DBP and HR at T3 were the same as those at T0 in the two groups（P >0.05）. Concentrations of E and NE were increased significantly at T1，T2 than at T0 in group T（P<0.05），higher than those in group L at the corresponding periods（P<0.05）. Levels of COR were higher at T1，T2 and T3 in group T than at T0 and in group L（P<0.01）. Conclu－sions：SLMA can effectively relieve the stress response of elderly patients with general anesthesia in total hip replacement，obviously better than the endotracheal tube.