Comparative dynamics of the level of cortisol during general anesthesia with the use of the laryngial mask and intubation of the trachea in patients operated for nodular thyroid gland formations
Abstract
The results of the examination of the cortisol content in the blood during general anesthesia in 60 patients operated on for thyroid nodular formations are analyzed. The first group (main group) -40 patients in whom ALV was carried out using the laryngial mask (LM); The 2nd (control) group - Ventilation was performed with intubation of the trachea (IT). The level of cortisol in the blood in both groups was determined in 4 stages: 1- the day before the operation; 2- when applying LM and IT; 3- with stromectomy and 4 th stage - with the application of the last sutures to the wound of the neck. The results of the studies showed that in both methods of ventilation the sympathetic-adrenal system is adequately protected, however, anesthesia with LM causes less stress response; so if during the imposition of LM the level of cortisol increased by 33% from the initial index, then in the second group (intubation of the trachea) this reached up to 35.7% (P <0.05). Similar proportions were more or less characteristic in the 4th stage. However, during the peak of the operation (stage 3 of the examination) in both groups, the level of cortisol in the blood was approaching the baseline, which proved the adequacy of anesthesia in both groups. In addition, the use of LM in the replacement of tracheal intubation, along with the least response of the stressful response of the body, can reduce the occurrence of unwanted symptoms in the postoperative period in the upper respiratory tract.
About the Authors
F. C. Hasanov
Научный Центр Хирургии им.М.А.Топчубашова
Russian Federation
Russian Federation
N. F. Muradov
Научный Центр Хирургии им.М.А.Топчубашова
Russian Federation
Russian Federation
A. N. Isayeva
Научный Центр Хирургии им.М.А.Топчубашова
Russian Federation
Russian Federation
References
1. Бримакомбе Д. Ларингеальная маска - новая концепция в поддержании проходимости верхних дыхательных путей / Д. Бримакомбе, М. Лукьянов М, Р. Кемпбелл // Анестезиол. и реаниматол. - 1997. - № 5. - С. 62-68.
2. The development of the laryngeal mask - A brief history of the invention, early clinical studies and experimental work from which the laryhgeal mask evolved / A.I.J. Brain //Eur. J. of Anaesth. - 1991. - Vol. 4. - P. 5-17.
3. Use of the laryngeal tube during emergence from anaesthesia in a patient with an unstable neck/ T. Asai (et al.) //Anaesthesia. - 2004. - Vol. 59, № 3. - P. 300301.
4. Airway protection and the laryngeal mask airway in sinus and nasal surgery / A. Kaplan [et al.] // Laryngoscope. - 2004. - Vol. 114, № 4. - P. 652-655.
5. Airway protection and the laryngeal mask airway in sinus and nasal surgery /A. Kaplan [et al.] // - 2004. -Vol. 114, № 4. - P. 652-65
6. Difficult airway management in a maxillofacial and cervical abnormality with intubating laryngeal mask airway / S.Saini (et al.) // J. Oral Maxillofac Surg. -2004. - Vol. 62, № 4. - P. 510-513.Laryngoscope.
7. Laryngeal resistance before and after minor surgery: endotracheal tube wersus Laryngeal Mask Airway / A. Tanaka (et al.) // Anaesthesiology. - 2003. - Vol. 99, № 2. - P. 252-258.
8. Condition of the larynx affected by the laryngeal mask during general anaesthesia / R.G. Aniutin (et al.) // Vestn Otorinolaringol. - 2002. - № 6. - P. 19-23.
9. Postoperative sore throat after ambulatory surgery / P.P. Higgins (et al.) // Br J Anaesth. - 2002. - Vol. 88, № 4. - P. 582-584.
10. Impact of laryngeal mask airway and tracheal tude on pulmonary function durind the early postoperative period / G. Natalini (et al.) //Acta Anaesthesiol Scand. - 2002. - Vol. 46, № 5. - P. 525-528.
11. ProSeal-laryngeal mask versus endotracheal intubation in patients undergoing gynaecologic laparoscopy /S.N. Piper (et al.) // Anaesthesiol Intensivmad Notfallmed Schmenzther. - 2004. - Vol. 39, № 3. - P. 132-137.
12. Мирасов, А. А. Общая анестезия с использованием ларингеальной маски при видеолапароскопических эхинококкэктомиях печени у детей//Автореферат дисс.к.м.н.;Новосибирск, 2012.
13. Шевченко В.П. Физиологические основы и проблемы использования ларингеальной маски / В.П. Шевченко. - Новосибирск: типография СО РАМН, 1997.230 с.,
14. Аверьянов Д.А., Черебилло В.Ю., Шаталов В.И., Щеголев А.В. Сравнение выраженности стресс-реакции при неингаляционной, комбинированной и сочетанной анестезиях при транссфеноидальных аденомэктомиях гипофиза // Анестезиология и Реаниматология, 2011, №4, с. 10-13.
15. Барабой В.А. Стресс: природа, биологическая роль, механизмы, исходы / Киев: Фитосоциоцентр - 2006. - 424 с
16. Клецкин С.З. Хирургический стресс и регуляция физиологических функций, М.: Медицина, 1983, 257 с.
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For citations:
Hasanov FC, Muradov NF, Isayeva AN. Comparative dynamics of the level of cortisol during general anesthesia with the use of the laryngial mask and intubation of the trachea in patients operated for nodular thyroid gland formations. Ural Medical Journal. 2018;(6):73-76. (In Russ.)
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