Comparative Study of Cardiovascular Response to Laryngoscopy With Endotracheal Intubation and Laryngeal Mask Airway Insertion
Background: Airwaymanagementis the most essential
maneuver during delivery of general anaesthesia.
Traditionally, laryngoscopy and endotracheal tube
(ETT) insertion has been the mainstay in providing
adequate airway management and delivering
anaesthesia. The laryngeal mask airway (LMA)
offers a much less invasive way of maintaining
the airway as it does not pass through the glottis
and does not require the use of the laryngoscope.
Laryngoscopy and ETT or LMA insertion are
noxious stimuli which provoke a transient but marked
sympathetic response manifesting as hypertension
Materials and Methods: A hospital
based comparative study was conducted to determine
the haemodynamic response elicited by laryngoscopy
and ETT and compare it with that elicited by LMA
in ASA I ( American Society Anesthesiologist) and
ASA II patients, undergoing elective surgeries at
Manipal Teaching Hospital.
Results: The change in
hemodynamic parameters after laryngoscopy and
ETT insertion were significantly greater than those
elicited by LMA (p<0.0001). The increase took
about 5 minutes to return to pre insertion values in
the ETT group, whereas about 3 minutes in the LMA
group. It took a significantly shorter time to insert
an LMA (12.63 sec) compared to ETT (22.76 sec).
Conclusion: The haemodynamic changes elicited
by LMA are less and short lived compared to those
elicited by laryngoscopy and ETT insertion. It takes
a shorter time and is much easier to insert an LMA
compared to ETT.