comparison of pressor respons following laryngeai mask airway vs laryngoscopy and endotracheal tube inserition

ABSTRACT

To test the hypothesis that laryngeal mask airway [LMA] insertion is associated with less pressor response as Compared to endotracheal intubation. A prospective, comparative study. Department of Anaesthesiology Intensive Care and Path Management, Nishtar Medical Institution Multan [Pakistan] from July 2007 to January 2008. 60 adult, ASA grades land II patients undergoing elective general surgery of less than one hour duration were divided in two groups with 30 patients in each. These patients were operated under general anaesthesia and either endotracheal tube [Group I] or LMA [Group II] was used to maintain the airway. The rise in heart rate, systolic and diastolic blood pressure was recorded before induction of anaesthesia and at one, three, five and ten minutes after insertion of laryngeal mask airway or tracheal tube and the results compared in both groups. A statistically significant rise in heart rate, systolic blood pressure and diastolic blood pressure was seen in group-I while statistically significant rise in heart rate only was seen in group-II subsequent to their insertion. Mean maximum increase was statistically more after laryngoscopy and endotracheal intubation than after laryngeal mask airway insertion. The duration of pressor responses was also longer after endotracheal intubation. Laryngeal mask airway is an acceptable alternative techinque offering advantages in terms of haemodynamic stability compared to tracheal intubation