Pressure responses following the insertion of pro-seal laryngeal mask airway in patients with controlled hypertension: A comparison with tracheal intubation

2018 ◽  
Vol 2 (S1) ◽  
pp. e000134
Author(s):  
Drashti Vavadia ◽  
Rupal Shah

Aims & Objectives: To compare:1) Hemodynamic responses during insertion of pro-seal laryngeal mask airway (PLMA) vs endo-tracheal tubation (ETT) in hypertensive patients under control. 2) The incidence of complications. Methods: A total of 30 patients aged between 45-60 years of ASA grade II having history of essential hypertension under control, were on oral medication who were posted for abdominal surgeries under GA were randomly divided into two groups of 15 each (One group for PLMA insertion and other for ETT insertion). The two groups were compared for pressor responses following insertion of PLMA or ETT. Results: After PLMA Insertion, mean pulse increased from 67±7 to 68±5 per minute, Systolic Blood Pressure (BP) increased from 123±1 to 127±5 per mmHg, Diastolic BP increased from 72±8 to 78±7 per mmHg and Mean Artery Pressure (MAP) increased from 89±11 to 94±8 mm Hg. After ETT insertion: Mean pulse increased from 68±2 to 80±8 per minute, Systolic BP increased from 124±1 to 152±8 per mmHg, Diastolic BP increased from 72±8 to 96±8 per mmHg and MAP increased from 89±10 to 115±4 mm Hg. Conclusion: We concluded that Proseal LMA is safe. It is judged by: Stable hemodynamics, adequate oxygenation, and ventilation and less complications.

1971 ◽  
Vol 41 (4) ◽  
pp. 321-331 ◽  
Author(s):  
T. A. Kotchen ◽  
P. J. Mulrow ◽  
L. B. Morrow ◽  
P. M. Shutkin ◽  
N. Marieb

1. The renin-aldosterone system was studied in seventy-one selected hypertensive patients. Nine (13%) were diagnosed as having primary aldosteronism. Of the twenty-three patients who presented with a history of unprovoked hypokalaemia, the incidence of primary aldosteronism was 40%. 2. Renin and aldosterone responses to the combined stimuli of a low sodium diet and the upright posture were suppressed in patients with essential hypertension. There was no evidence that the suppression was due to abnormal adrenal function, sympathetic neuropathy, or the level of the blood pressure. The mechanism of the suppressed plasma renin activity response and its significance in the pathogenesis of hypertension are unknown.


2019 ◽  
Author(s):  
Mehdi Sanatkar ◽  
Mehrdad Goudarzi ◽  
Alireza Ebrahim Soltani

 We compared hemodynamic responses following laryngeal mask airway insertion versus tracheal intubation in hypertensive patients who were scheduled for elective ophthalmic surgery under general anesthesia. We studied 48 controlled hypertensive patients that were randomly divided into two groups (n=24) for insertion of laryngeal mask airway (LMA) and endotracheal intubation (EI). The mean arterial blood pressure (MAP), heart rate, rate pressure product (RPP), and ST-segment changes were recorded preoperatively, immediately preintubation and 1, 3, and 5 minutes after LMA insertion or tracheal intubation in all patients and compared between two groups. There was a reduction in MAP after induction and immediately preintubation in all of patients of both groups (P<0.05). The MAP, heart rate and RPP increased immediately after both LMA insertion and tracheal intubation (P<0.05). The elevation of MAP and RPP were maintained for longer time in intubation group versus LMA group (P<0.05). There was no difference between the groups with respect to ST-segment variation. The incidence of airway injury was similar between two groups. The laryngeal mask airway insertion may be preferable to endotracheal intubation in hypertensive patients where attenuation of hemodynamic stress response is desired. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(5):289-294.


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