Stabilizing hemodynamic and reducing pulmonary complications during extubation with switching endotracheal tube to laryngeal mask in craniotomies
recruit ASA: 1-3, 20-65 years old undergoing neurosurgery under general anesthesia Excluded 1.Decline to participated 2.Difficult airway 3.Body Mass Index \>30 4. Pregnant woman 5.Nothing Per Os \<8hrs(case number:80). General anesthesia Induction: 0.15-0.2 mg/kg cisatracurium or 0.6-1.2mg rocuronium , 1.5-2 mg/kg propofol, 1-2 mcg/kg Fentanyl. Endotracheal tube 6.5-7.5mm. Maintenance with sevoflurane 2- 3% FiO2:100%. Optimal muscle tension monitor. When surgery done, sevoflurane at 2.63-2.97% Then randomly assigned two group Anesthesia group(control group) : Removed endotracheal tube at sevoflurane at 2-3% Switching group (intervention group): Intervention with endotracheal tube to laryngeal mask, and removing laryngeal mask at sevoflurane: 0.4MAC
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
62
Switching endotracheal tube to laryngeal mask at sevoflurane 2.63-2.97%, Removing endotracheal tube when spontaneously generating tidal volume of \>4ml/kg, EtCO2\<45mmHg, Train of four ratio \>70-90%.
Wei Cheng-Fong
Taoyuan, Taiwan
Hemodynamic
Blood pressure including systolic, diastolic and mean arterial pressure and heart rate during extubation
Time frame: 30 minutes
Pulmonary complications
Rate of Participants with Cough, Bucking, Laryngospasm, Aspiration, Desaturation(SpO2%\< 90%) and Need airway assist device(Nasal or oral airway)
Time frame: 24 hours
Partial pressure of carbon dioxide in arterial blood
Partial pressure of carbon dioxide in arterial blood five minutes before and after extubation
Time frame: 20 mins
Re-do surgery
Number of Participants with Re-do neurosurgery within 24hours
Time frame: 24 hours
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