Comparative Study of Cardiovascular Response to Laryngoscopy With Endotracheal Intubation and Laryngeal Mask Airway Insertion

Abstract

Background: Airway management is the most essential manoeuvre during delivery of general anaesthesia. Traditionally, laryngoscopy and endotracheal tube (ETT) insertion has been the mainstay in providing adequate airway management and delivering anaesthesia. The laryngeal mask airway (LMA) offers a much less invasive way of maintaining the airway as it does not pass through the glottis and does not require the use of the laryngoscope. Laryngoscopy and ETT or LMA insertion are noxious stimuli which provoke a transient but marked sympathetic response manifesting as hypertension and tachycardia.

Materials and Methods: A hospital based comparative study was conducted to determine the haemodynamic response elicited by laryngoscopy and ETT and compare it with that elicited by LMA in ASA I (American Society Anesthesiologist) and ASA II patients, undergoing elective surgeries at Manipal Teaching Hospital.

Results: The change in hemodynamic parameters after laryngoscopy and ETT insertion were significantly greater than those elicited by LMA (p<0.0001). The increase took about 5 minutes to return to pre insertion values in the ETT group, whereas about 3 minutes in the LMA group. It took a significantly shorter time to insert an LMA (12.63 sec) compared to ETT (22.76 sec).

Conclusion: The haemodynamic changes elicited by LMA are less and short lived compared to those elicited by laryngoscopy and ETT insertion. It takes a shorter time and is much easier to insert an LMA compared to ETT.