Comparative Study of Cardiovascular Response to Laryngoscopy With Endotracheal Intubation and Laryngeal Mask Airway Insertion

Hari Poudel; Rabin Sundar Shrestha; S.N Bawa

1. Alan R. Aitkenhead, David J. Rowbotham,
Graham Smith. Text book of Anaesthesia.
4th ed. Churchill Livingstone; 2001, 101-6,
423-514.
2. Edward Morgan G. Jr, Maged S.
Mikhail, Michael J. Murray. Clinical
Anaesthesiology. 4th ed. Lange Medical
Books; McGrawn-Hill Medical Publishing
Division; 2008, 97-110.
3. Masson AHB. Pulmonary oedema during or
after surgery. Anesthesia Analgesia. 1964;
43:440.
4. Wilson IG, Fell D, Robinson SL, Smith G.
Cardiovascular responses to insertion of the
laryngeal mask. Anaesthesia 1992; 47: 300-
02.
5. Jamil SN et al. Comparison of LMA and
endotracheal intubation in children Indian
Journal of Anaesthesia 2009; 53 (2):174-78.
6. Low JM, Harvey JT, Prys-Roberts C,
Dagnino J. Studies of anaesthesia in
relation to hypertension. VII: Adrenergic
responses to laryngoscopy. British Journal
of Anaesthesia 1986; 58:471-77.
7. Hickey S, Cameron AE, Asbury AJ.
Cardiovascular response to insertion of
Brain’s laryngeal mask. Anaesthesia 1990;
45: 629-33.
8. Millar Forbes A, Dally FG. Acute
hypertension during induction of anaesthesia and endotracheal intubation in normotensive
man. British Journal of Anaesthesia 1970;
42:618-24,37.
9. Russell WJ, Morris RG, Frewin DB, Drew
SE. Changes in plasma catecholamine
concentrations during endotracheal
intubation. British Journal of Anaesthesia
1981; 53:837-9.
10. Anita N. Shetty, Shinde VS, Chaudhari
LJ. A comparative study of various airway
devices as regards ease of insertion and
haemodynamic responses. Indian Journal of
Anaesthesia 2004; 48(2): 134-7.
11. Takashi Asai, Stephen Morris. The laryngeal
mask airway: its features, effects and role.
Canadian Journal of Anaesthesiology 1994;
41:930-60.
12. Oczenski W, Krenn H, Dahaba AA, et al.
Hemodynamic and catecholamine stress
responses to insertion of the Combitube®,
laryngeal mask airway or tracheal intubation.
Anesth Analg1999; 88:1389–94.
13. O. Ajuzieogu., A. Amucheazi. & H. Ezike:
Blood Pressure And Heart Rate Responses
To Insertion Of The Laryngeal Mask Airway
Or Tracheal Intubation. The Internet Journal
of Anesthesiology. 2010;27 (2).
14. Shinji T., Taro M., Masayuki M., Hidenori
T. Haemodynamic responses to Tracheal
Intubation with Laryngoscope Versus
Lightwand Intubating device (Trachlight) In
Adults with Normal Airway. AnesthAnalg
2002; 95, no 2: 480-84.
15. Braude N, Clements EAF, Hodges UM,
Andrews BP. The pressor response and
laryngeal mask insertion. A comparison
with tracheal intubation. Anaesthesia 1989;
44: 551-4.
16. Griffin RM, Dodd P, Buckoke PC, Tosh
GC, Day SJ. Cardiovascular responses to
insertion of the brain laryngeal mask. British
Journal of Anaesthesia 1989; 63:624-25.
17. Low JM, Harvey JT, Prys-Roberts C,
Dagnino J. Studies of anaesthesia in
relation to hypertension. VII: Adrenergic
responses to laryngoscopy. British Journal
of Anaesthesia 1986; 58:471-77.
18. Shribman AJ, Smith G, Achola KJ.
Cardiovascular and catecholamine responses
ton laryngoscopy with and without tracheal
intubation. British Journal of Anaesthesia
1987; 59: 295-99.

Abstract viewed - 1183 times
pdf downloaded - 806 times

Downloads

Download data is not yet available.

Affiliations

Hari Poudel
Department of Anesthesia, Manipal College of Medical Sciences, Phulbari-11, Pokhara, Nepal

Rabin Sundar Shrestha
Affiliation not stated

S.N Bawa
Affiliation not stated

Content Top

Comparative Study of Cardiovascular Response to Laryngoscopy With Endotracheal Intubation and Laryngeal Mask Airway Insertion

Hari Poudel ,
Rabin Sundar Shrestha ,
S.N Bawa

Vol 2 No 2 (2019): Medical Journal of Pokhara Academy of Health Sciences

Online Submission: Mar 2, 2020

Published: Mar 1, 2020

Abstract

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
and tachycardia.

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.

Keywords: Airway, Endotracheal intubation, Laryngoscopy, Laryngeal mask airway