Effects Of Replacement Of Double-lumen Endobronchial Tube With Laryngeal Mask Airway During Recovery Of Anesthesia In Elderly Hypertensive Patients

Objective：Removal of the endotracheal tube from patients during recoveryof anesthesia may lead to evident increase in heart rate and arterial andintracranial pressure as well as to myocardial ischemia and malignanthypertension in hypertensive cases, even such serious consequences asmyocardial infarction, cerebral vascular accident,etc.,exerting negativeimpacts on post-operative recovery. The study was designed to investigateaffects of replacement of double-lumen endobronchial tube with thelaryngeal mask airway(LMA) during recovery of anesthesia in elderlyhypertensive patients after pulmonary lobectomy and to probe into thefeasibility and safety so as to provide reference to a certain extent forclinical application.Methods：Eighty elderly hypertensive patients of pulmonary lobectomy agedfrom63to83years under general anesthesia were randomly divided into twogroups，One group of patients were extubated double-lumen endobronchial tubewhile awake(group TT，n=40)and the other group were extubated first andthen treated with LMA under deep anesthesia immediately(group LM，n=40)．ASAof the patients were Ⅱor Ⅲ. The data of systolic blood pressure(SBP)，diastolic blood pressure(DBP)，heart rate(HR)and rate pressureproduct(RPP) were collected before and after extubation in group of LM. Inaddition to SBP, DBP, HR, RPP,pulse oxygen saturation(SP02)， were alsocollected prior to induction of anesthesia(To)，suction(T1)and at0min(T2)，5min(T3) after treatment with extubating tracheal tube or LMA inboth groups．Furthermore, the complications such as coughing, bucking andrestlessness were compared after treated with extubating double-lumenendobronchial tube or LMA between two groups．After being extubated in two groups5mins,the number of cases whose HR＞100bpm were collected.Results:(1)There was no significant difference in SBP,DBP,HR,Sp02betweenpatients treated with extubate double-lumen endobronchial tube andtreated with LMA under deep anesthesia in group of LM(P>0．05);(2)The dateSBP,DBP,HR,Sp02were not significantly different at T0,T1,T2,T3in group ofLM(P>0．05);(3) SBP，DBP，HR and RPP at T1,T2,T3increased significantly afterextubation compared to those at T0in group of TT(P<0．05);(4)There weresignificant raises in SBP,DBP,HR,Sp02at T1,T2,T3than those in group of LM(P<0．05);(5) While complications such as coughing and bucking in group ofTT was32(80.0%),restlessness during the recovery stage in group of TT was13（32.5%），which were more severe than those in group of LM0（0），0（0）(P<0．01);（6）There was significant difference in HR﹥100bpm in gpoupof TT patients16(40%) than those in group of LM3(7.5%)(P<0．05);(7) Therewas no significant difference in SpO2between groups of TT with LM (P>0．05).Conclusion:Replacemnt of double-lumen endobronchial tube with LMA couldeffectively prevent elderly patients’response at extubation duringrecovery of anesthesia. It is suitable for elderly hypertensive patientson pulmonary lobectomy...