Title: Hemodynamic Response in Hypertensive Patients with Endotracheal intubation and Laryngeal mask airway- A Comparative study
Authors: Dr Irukulla Avanthi, Dr Uppalapati Swathi, Dr S.Manohar
DOI: https://dx.doi.org/10.18535/jmscr/v6i10.39
Abstract
The haemodynamic response associated with laryngoscopy and tracheal intubation may be harmful to certain patients. The laryngeal mask airway (LMA) avoids the need for laryngoscopy and allows positive pressure ventilation of the lungs in appropriate patients. This study compared the haemodynamic response of tracheal intubation with that of mask insert ion in hypertensive patients. Sixty hypertensive patients between 40-60 years of either sex of ASA grade II were randomly allotted to one of the two groups of 30 each (group ET vs group LMA). LMA insert ion or tracheal intubation was performed after induct ion of anaesthesia with thiopentone, and muscle relaxation with succinylcholine. The heart rate, systolic BP, diastolic BP, mean arterial pressure (MAP) and rate pressure product (RPP) were measured after induct ion, immediately after intubation or insert ion and at minute 1, 3 and 5. There was a very highly significant difference (P < 0.001) in mean peak increase in heart rate (59.2% in group ET vs 36% in group LMA). The increase in arterial pressures were very similar. The systolic BP increased by 29.5% in group ET compared with 27% in group LMA and diastolic BP increased by 15.2% and 16.2% in group ET and group LMA respectively. The MAP and RPP reached maximum values immediately after airway instrumentation. However, the values after LMA insert ion were significantly lower compared to tracheal intubation after one minute. Use of LMA may therefore offer some limited advantages over tracheal intubation in the anaesthetic management o f patients where the avoidance of the pressure response is of particular concern.
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