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

2019 ◽  
Vol 2 (2) ◽  
pp. 197-204
Author(s):  
Hari Poudel ◽  
Rabin Sundar Shrestha ◽  
S.N. Bawa

Background: Airway management is the most essential manoeuvre 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.

2014 ◽  
Vol 23 (2) ◽  
pp. 51-55
Author(s):  
Azizul Gafur ◽  
Mustafa Kamal ◽  
Ashia Alia ◽  
Idris Ali ◽  
Amirul Islam ◽  
...  

Background Laryngeal mask airway insertion causes less changes of haemodynamic parameters. As haemodynamic changes during laryngoscopy and endotracheal intubation as result of intense stimulation of sympathetic nerves system. Objective To find out the effective airway management by LMA during controlled ventilation, to avoid laryngoscopic and intubation induced haemodynamic changes and to avoid laryngospasm and bronchospasm. Method A total number of 100 patients ASA grade I & II were selected randomly as per inclusion and exclusion criteria in two groups. Fifty in each group. In group A used LMA and in group B used ETT during general anaesthesia in intermediate duration of gynaecological operation. Pulse,NIBP,SpO2 were recorded in perioperatively. Result Pulse, blood pressure were significant between the two groups (p<0.00) but in SpO2 was insignificant except in 2 min of intraoperative which was significant. (p<0.013). Conclusion LMA insertion causes less changes of haemodynamic parameters when compared with that of ET intubation. Our finding suggests that LMA can be safe and beneficial alternative to ETT. DOI: http://dx.doi.org/10.3329/jbsa.v23i2.18174 Journal of BSA, 2009; 23(2): 51-55


2004 ◽  
Vol 100 (2) ◽  
pp. 267-273 ◽  
Author(s):  
Ron Flaishon ◽  
Alexander Sotman ◽  
Alan Friedman ◽  
Ron Ben-Abraham ◽  
Valery Rudick ◽  
...  

Background Mass casualty situations impose special difficulties in airway management, even for experienced caregivers. The laryngeal mask airway is part of the difficult airway algorithm. The authors evaluated the success rate and the time to secure airways by mask by anesthetists, surgeons, and novices when wearing either surgical attire or full antichemical protective gear that included butyl rubber gloves and a filtering antigas mask. Methods Twenty anesthetists and 22 surgeons with 2-5 yr of residency inserted a laryngeal mask airway in 84 anesthetized patients, and 6 novices repetitively inserted masks in 57 patients under both conditions in a prospective, randomized, crossover manner. The duration of insertion was measured from the time the device was first grasped until a normal capnography recording was obtained. Results Anesthetists needed 39 +/- 14 s to insert the masks when wearing surgical attire and 40 +/- 12 s with protective gear. In contrast, surgery residents needed 64 +/- 40 and 102 +/- 40 s (P = 0.0001), respectively. Anesthetists inserted masks in a single attempt, whereas the surgeons needed up to four attempts with no hypoxia or failure associated. The initial attire-wearing novices' insertions took as long as the surgeons'; three of them then reached the mean performance time of the anesthetists after four (protective gear) and two (surgical attire) trials, with only one occurrence of hypoxia and a failure rate similar to that of the surgeons. Conclusions Anesthesia residents insert laryngeal mask airways at a similar speed when wearing surgical attire or limiting antichemical protective gear and two to three times faster than surgical residents or novices wearing either outfit. Novices initially perform at the level of surgical residents, but their learning curve was quick under both conditions.


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