Publications

Aim: The aim of this study was to compare the hemodynamic
response between laryngoscopy with endotracheal intubation
and laryngeal mask insertion. The study also compared imme-
diate postoperative complications between laryngeal mask
airway (LMA) and endotracheal intubation.
Materials and methods: Fifty-five American Society of
Anesthesiologists (ASA) physical status I and II adult patients
who underwent elective surgeries under general anesthesia
were included in either group I—LMA or group II—endotracheal
tube (ETT). Patients were induced with intravenous (IV) propofol,
fentanyl, and atracurium. After intubation/insertion, patients were
mechanically ventilated and isoflurane was used to maintain ade-
quate level of anesthesia with N2O/oxygen mixture. Hemodynamic
parameters were measured before induction and after insertion
of the airway device every minute for the first 10 minutes and
every 5 minutes after that for the first half hour following insertion
of the airway device.
Results: A significant and longer increase in heart rate (HR)
was noted after ETT intubation as compared with LMA group.
However, a decrease in systolic, diastolic, and mean arterial
pressures (SBP, DBP, and MAP) was noted after both LMA
insertion and ETT intubation. The decrease was significantly
more in LMA group (p < 0.001). Complications of postoperative
sore throat and hoarseness of voice were also significantly
more in ETT group.
Conclusion: Pressor responses might be of no clinical
importance in the healthy, normotensive patients, but might
be harmful in patients with hypertension, aortic or cerebral
aneurysm, raised intracranial pressure, or other cardiovascular
diseases. In such cases, the attenuated response of the LMA
might be desirable. Therefore, where appropriate, the use of
the LMA would be recommended in such patients to avoid the
marked response produced by the ETT.