Efficacy of laryngeal mask airway Supreme in elderly patients with hypertension

Objective To evaluate the efficacy of laryngeal mask airway (LMA) Supreme in the elderlypatients with hypertension.Methods Forty elderly patients with more than 1-year history of hypertension,aged65-75 yr,weighing 45-70 kg,with body mass index ＜ 35 kg/m2,were randomized into 2 groups (n=20 each):intratracheal intubation group (group T) and LMA Supreme group (group S).Anesthesia was induced with fenta-nyl,propofol and vecuronium.LMA Supreme was inserted in group S or intratracheal intubation was performed ingroup T for mechanical ventilation.Anesthesia was maintained with sevoflurane,propofol and vecuronium.Thesystolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR) and pulse oxygen saturation(SpO2) were recorded after entering the operating room (T0),at 0,1,2 and 5 min after LMA insertion or intuba-tion (T1-4),at skin incision (T5),and immediately after removal of LMA or extubation (T6).Venous blood samples were taken at T0-4,6 for determination of plasma epinephrine (AE),noradrenaline (NE) and dopamine (DA)concentrations.The insertion and removal responses,LMA insertion/intubation time and the number of inserting LMA/intubation were recorded.The lung compliance,airway peak pressure,airway sealing pressure and airway plateau pressure were detected after LMA insertion/intubation.The side effects occurred in the pharynx were recorded after removal of LMA or extubation.Results Compared with group T,the SBP,HR,insertion and removal responses,incidence of side effects and plasma AE,NE and DA concentrations were significantly decreased and LMA insertion/intubation time was significantly shortened in group S (P ＜ 0.05).Compared with the baseline value at T0,the concentration of plasma NE was significantly increased at T2 in group S,the concentration of plasma NE was significantly increased at T1-4.6 and the concentration of plasma AE and DA was significantly increased at T1.3 in group T (P ＜ 0.05).Conclusion LMA Supreme has better efficacy for airway management in the elderly patients with hypertension than intratracheal intubation,with lower insertion and removal responses and fewer side effects occurred in the pharynx. Key words: Laryngeal mask; Intratracheal intubation; Hypertension; Elderly