hemodynamic effects and complications of tracheal intubation with intubating laryngeal mask airway: a comparison with direct laryngoscopy

ABSTRACT

The intubating laryngeal mask airway [ILMA] is designed to facilitate blind tracheal intubation. Direct laryngoscopy, to facilitate tracheal intubation, produces a marked pressor response. This randomized, controlled study -was undertaken to compare the complications of insertion and hemodynamic effects following tracheal intubation through intubating laryngeal mask airway [ILMA] with that of conventional Macintosh laryngoscope. One hundred adult patients undergoing elective surgery were randomly allocated into two equal-sized groups. All patients received general anesthesia using a standard balanced anesthesia technique. Tracheal intubation was performed using either intubating laryngeal mask airway or Macintosh laryngoscope. The intubation time, number of attempts required for successful intubation, the problems encountered during intubation, hemodynamic changes and postoperative pharyngolaryngeal complications were recorded. Time to intubation was comparatively longer in ILM.4 group than laryngoscopy group [58.6 +/- 8.2 sec. versus 29.2 +/- 5.6 sec. p <0.001]. The overall intubation success rate was comparable among the two study groups. The changes-in mean blood pressure were significantly less in ILMA group as compared to laryngoscope group [p <0.05]. The incidence of postoperative sore throat and hoarseness of voice was comparable among groups. Our results suggest that ILMA offers advantage over laryngoscope in minimizing the hemodynamic effects to intubation. Therefore, it can be used as a suitable alternative to laryngoscopy for tracheal intubation