Limiting Emergence Phenomena After General Anesthesia With Combined LMA and ETT Airway Management Technique

Study Summary

Emergence from general anesthesia with a laryngeal mask airway compared with an endotracheal tube has been shown to favorable with respect to limiting emergence phenomena such as coughing, straining, restlessness, and sympathetic stimulation leading to hypertension and tachycardia. Many anesthesiologists would prefer the use of an ETT to an LMA in cases in which higher ventilation pressures may be required, in those patients who are perceived to be high risk for reflux and pulmonary aspiration of gastric contents, as well as during cases that allow the anesthesiologist to have little accessibility the airway. The aim of this study is to investigate an airway management technique that would allow for the benefits of the ETT in terms of a secure airway for the duration of the surgical procedure as well the potential for less emergence phenomena seen when emerging with an LMA.

Primary Outcome

Difference in heart rate multiplied by systolic blood pressure measured during the \~5 minutes prior to emergence and the \~5 minutes after removal of the airway device. Heart rate is continuously monitored and recorded at one minute intervals. Blood pressure is intermittently monitored at 3 minute intervals. The two SBPs measured prior to removal of the airway device will be multiplied by the HR at those times and the RPPs will be averaged. This will be compared with average of the product of t

Conditions Studied

Interventions

• PROCEDURE Induction of anesthesia
• DEVICE Placement of LMA [Ambu (R) AuraGain (TM) disposable laryngeal mask]
• DEVICE Laryngoscopy and placement of ETT
• PROCEDURE Ventilation via the ETT
• PROCEDURE Removal of the ETT

Study Locations (1)