AN OBSERVATIONAL STUDY TO EVALUATE THE HAEMODYNAMIC CHANGES BETWEEN ENDOTRACHEAL INTUBATION AND LARYNGEAL MASK AIRWAY INSERTION

Author:

Kumar Rahul1,Prakash Anant2,Choudhary Chandeshwar3,Jana Debarshi4

Affiliation:

1. MBBS, M.D. (Anaes.), Assistant Professor, Department of Anaesthesiology, Sri Krishna Medical College & Hospital, Muzaffarpur, Bihar

2. MBBS, M.D. (Anaes.), Assistant Professor, Department of Anaesthesiology, Sri Krishna Medical College & Hospital, Muzaffarpur, Bihar.

3. MBBS, M.D. (Anaes.), Associate Professor, Department of Anaesthesiology, Sri Krishna Medical College & Hospital, Muzaffarpur, Bihar.

4. Young Scientist (DST), Institute of Post-Graduate Medical Education and Research, A.J.C. Bose Road, Kolkata, West Bengal, India-700020.

Abstract

Introduction: Airway management is a crucial skill for the clinical anaesthesiologist. It is an integral part of general anesthesia, allowing ventilation and oxygenation as well as a mode for anesthetic gas delivery. The laryngeal mask airways (LMA) have become popular in airway management as a missing link between facemask and tracheal tube in terms of both anatomical position and degree of invasiveness. Haemodynamic stability is an important aspect to the anaesthesiologist for the benet of the patients especially during intubations, laryngeal mask insertion. Laryngoscopy and endotracheal intubation can cause striking changes in Haemodynamics as result of intense stimulation of sympathetic nervous system. The aim of this study was to evaluate the hemodynamic changes between endotracheal intubation and laryngeal mask airway insertion. Material And Methods: This was a prospective observational study on 46 patients of ASA I-II status divided into 2 groups of 23 each. In the ETT (Endotracheal tube) group endotracheal intubation was done using Macintosh laryngoscope by using portex cuffed endotracheal while in LMA (Laryngeal mask airway) group laryngeal mask airway was inserted according to the standard recommendation. Heart rate, Systolic, Diastolic and Mean arterial pressure and dysrhythmias were monitored. Results: The two groups were comparable in terms of demographic data as there were no signicant differences between the 2 groups in terms of age, sex, duration of surgery, ASA grades and MPC classication. Heart rate (HR), Systolic blood pressure (SBP), Diastolic blood pressure(DBP), Mean arterial pressure (MAP) remains on higher side in ETT group than LMA group which was statistically signicant. P<0.05. Dysrhythmias were noted in 2 patients of ETT group while LMA group did not notice any dysrhythmias. Conclusion: This study demonstrated that there is a haemodynamic response consisting of an increase in Heart rate, SBP, DBP and MAP that comes with ETT insertion as well as with LMA insertion. However, the response caused by ETT insertion is signicantly greater than that caused by LMA insertion.

Publisher

World Wide Journals

Reference20 articles.

1. Anita N. Shetty, Shinde VS, Chaudhari LJ. A comparative study of various airway devices as regards ease of insertion and haemodynamic responses. Indian Journal of Anaesthesia 2004; 48: 134-137.

2. Edward Morgan G. Jr, Maged S. Mikhail, Michael J. Murray. Clinical Anaesthesiology. 5th ed. Lange Medical Books; McGrawn-Hill Medical Publishing Division 2013:.309-341.

3. Holden R. Morsman CDG. Butler J. Clark GS. Hughes. DS. Bacon P.J. Intraocular pressure changes using the LMA and ETT. Anaesthesia 1991:46; 922-4.

4. K. Montazari, Kh. Naghibi and S.J. Hashemi. Comparison of hemodynamic changes after insertion of Laryngeal mask airway, Facemask and Endotracheal intubation. Journal of Acta Medica Iranica- 2004; 42: 437- 440.

5. Kihara S, Yaguchi Y et al. Hemodynamic Responses among Three Tracheal Intubation Devices in Normotensive and Hypertensive Patients. IARS; Anesthesia & Analgesia 2003;96;890-895.

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