ORIGINAL ARTICLE   

Chirurgia 2020 June;33(3):123-9

DOI: 10.23736/S0394-9508.19.05018-6

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Comparison between Air-Q SP and endotracheal intubation during general anesthesia for endovascular coiling of unruptured cerebral aneurysms

Yeojung KIM ¹, Boohwi HONG ^{1, 2}, Hyunwoo PARK ¹, Soo-Kyoung YOUN ¹, Seojin SIM ¹, Chae-Seong LIM ^{1, 2}, Woosuk CHUNG ^{1, 2}, Seok-Hwa YOON ^{1, 2} ✉

¹ Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, South Korea; ² Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon, South Korea

BACKGROUND: Endotracheal intubation is commonly used to maintain the airway during general anesthesia for coil embolization of cerebral aneurysm. However, endotracheal intubation and direct laryngoscopy lead to hemodynamic stress responses, increasing the risk of aneurysm rupture. Use of the Air-Q Self-Pressurizing (SP), a less invasive supraglottic airway device, may result in hemodynamic stability and fewer respiratory complications. The aim of the present study was to compare hemodynamic changes and complications during general anesthesia for coil embolization using endotracheal intubation via direct laryngoscopy and Air-Q SP insertion.
METHODS: Sixty-nine patients scheduled for coil embolization under general anesthesia were randomly allocated into one of two groups, the endotracheal intubation group (ETT group) or the Air-Q SP group (Air-Q group). Blood pressure (BP) and heart rate (HR) were compared between the two groups at baseline, after propofol injection, and at device insertion and removal. Postoperative respiratory symptoms and length of hospital stay were also compared.
RESULTS: Hemodynamic changes in the Air-Q group were significantly lower than those in the ETT group [HR (P<0.001), systolic BP (P<0.001), and diastolic BP (P=0.007)]. Hemodynamic values were significantly lower in the Air-Q group compared with those in the ETT group at device insertion [HR (P=0.001), systolic BP (P=0.001), and diastolic BP (P=0.019)]. There were no critical complications.
CONCLUSIONS: Compared to endotracheal intubation, the Air-Q SP minimizes hemodynamic changes and may reduce the risk of aneurysm rupture in patients undergoing general anesthesia for coil embolization.

KEY WORDS: Aneurysms; Therapeutic embolization; Intubation; Hemodynamics; Airway management