Comparison between endo-tracheal tube, laryngeal mask airway, combitube and streamlined liner pharynx airway

ABSTRACT

In a prospective, randomized trial 80 patients scheduled for gynacological, urological and lower abdominal procedures in supine position were randomly allocated to one of four groups to evaluate time of insertion, insertion with resistance, number of attempt of insertion, hemodynamic changes, catecholamine level, fibro-optic score, maximum inspiratory peak airway pressure, trauma and post-operative complications after insertion of ET, LMA, CT, SLIPA. All four devices could be inserted easy and rapidly with shorter time of insertion in LMA than SLIPA, and all providing adequate ventilation and oxygenation with higher peak inspiratory airway pressure in CT than the other three groups. Also insertion of CT was associated with significant increase in MAP compared with ET, LMA or SLIPA respectively. While the catecholamine level were significantly higher after insertion of CT than the ET, LMA or SLIPA. Finally, sore throat, hematoma, mucosal laceration and dysphagia occurred more often in CT group than the other groups. While in LMA or SLIPA there is no suffering from sore throat or dysphagia. We conclude that the four devices providing adequate ventilation and oxygenation, but the SLIPA is useful alternative to the other three groups with easy of insertion, less hemodynamic, less catecholamine release response and less complications, so it useful in elective patient specially with cardiovascular disease