Changes in Haemodynamic Parameters during off Pump Coronary Artery Bypass Grafting (CABG) in Patients with Ejection Fraction ≥40%

ABSTRACT

Introduction: Airway management is a crucial skill for theclinical anaesthesiologist. It is an integral part of generalanesthesia, allowing ventilation and oxygenation as wellas a mode for anesthetic gas delivery. The laryngeal maskairways(LMA) have become popular in airway managementas a missing link between facemask and tracheal tube interms of both anatomical position and degree of invasiveness.Haemodynamic stability is an important aspect to theanaesthesiologist for the benefit of the patients especiallyduring intubations, laryngeal mask insertion. Laryngoscopyand endotracheal intubation can cause striking changes inHaemodynamics as result of intense stimulation of sympatheticnervous system. The aim of this study was to evaluate thehemodynamic changes between endotracheal intubation andlaryngeal mask airway insertion.Material and Methods: This was a prospective observationalstudy on 46 patients of ASA I-II status divided into 2 groups of23 each. In the ETT (Endotracheal tube) group endotrachealintubation was done using Macintosh laryngoscope by usingportex cuffed endotracheal while in LMA (Laryngeal maskairway) group laryngeal mask airway was inserted accordingto the standard recommendation. Heart rate, Systolic, Diastolicand Mean arterial pressure and dysrhythmias were monitored.Results: The two groups were comparable in terms ofdemographic data as there were no significant differencesbetween the 2 groups in terms of age, sex, duration of surgery,ASA grades and MPC classification. Heart rate (HR), Systolicblood pressure (SBP), Diastolic blood pressure(DBP), Meanarterial pressure (MAP) remains on higher side in ETT groupthan LMA group which was statistically significant. P<0.05.Dysrhythmias were noted in 2 patients of ETT group whileLMA group did not notice any dysrhythmias.Conclusion: This study demonstrated that there is ahaemodynamic response consisting of an increase in Heartrate, SBP, DBP and MAP that comes with ETT insertion aswell as with LMA insertion. However, the response causedby ETT insertion is significantly greater than that caused byLMA insertion.