Online ISSN: 2515-8260

COMPARATIVE ASSESSMENT OF I-GEL SUPRAGLOTTIC AIRWAY INTERVENTION VERSUS STANDARD TECHNIQUE OF ENDOTRACHEAL EXTUBATION FOR ATTENUATION OF PRESSOR RESPONSE IN CONTROLLED HYPERTENSIVE PATIENTS

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Dr. Sahana Ganesh Rajan, Dr. V. Jayaraman, Dr. Swathi. S, Dr. Shivanika Selvam

Abstract

Aim: The goal of this study is to compare the use of I-Gel intervention (Bailey’s manoeuvre) before endotracheal extubation, versus conventional extubation, in controlled hypertensive patients under general anaesthesia and thus check for the efficiency of the manoeuvre in attenuating pressor response at extubation. Materials and Methods: After ethics committee approval 68 patients belonging to ASA II, controlled hypertensives, undergoing elective surgeries under general anaesthesia were randomized into two groups of 34 each. 10 minutes before the end of the surgery at Sevoflurane MAC 1, patients belonging to the I-Gel study group were extubated at a deep plane after I-Gel placement. The patients in the ETT group had the endotracheal tube retained. Both groups of patients then had their airways extubated as per standard extubation criteria and HEART RATE, SBP,DBP, MAP,spO2 at 0,1,3,6,8,10 minutes post extubation observed. Coughing, bucking and ECG changes were compared between both groups. Ease of insertion of I-Gel and desaturation during exchange was also observed. Results: There was a significantly lesser heart rate, SBP, MAP elevation in the I-Gel group when compared to the endotracheal tube group. However less significant difference in diastolic blood pressure and no difference in oxygen saturation was present. The patients in I-Gel group also had statistically significant lower occurrence of coughing and bucking at extubation. Conclusion: The Bailey’s manoeuvre is a smooth and effective technique and elicits much lesser haemodynamic response in terms of heart rate, SBP, MAP at extubation in controlled hypertensive patients.

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