Comparison between tracheal intubation using the intubating laryngeal mask and conventional direct laryngoscopy regarding time, success rate and stress response during manual in-line stabilization of the neck

ABSTRACT

The aim of the study was to compare between the tracheal intubation through the intubating laryngeal mask [ILM] and by direct laryngoscopy during manual in-line stabilization [MILNS] of the head and neck as regard time, success of insertion and stress response to intubation and postoperative complications. The study was carried out on forty ASA I-II patients divided equally into two groups. The DL group where intubation was tried by direct laryngoscopy and ILM group where intubation was tried through the ILM during MILNS. We measured the time of insertion of ETT, the number of successful intubation, the number of intubation failure, the hemodynamic responses and hormonal stress response. The time of insertion of ETT was shorter in DL group than ILM group, the number of cases of intubation failure was larger in DL group than ILM group. The mean arterial pressure and heart rate increased at 2, 4 and 6 minutes after induction significantly in both groups and the increase was more in DL group than JLM group. The plasma concentration of norepinephrine increased significantly in both DL and ILM groups 10 minutes after tracheal intubation but the increase was more sigificant in DL group than ILM group. In conclusion, ILMA may be superior to direct laryngoscopy for Intubation in elective patients with cervical spine disorder with respect to reliability, safety and decreased stress response