Comparison of haemodynamic responses to insertion of Classic LMA and endotracheal tube: A randomized controlled study in adult patients posted for elective surgery under general anaesthesia

Abstract

Aim: The purpose of this study is to compare the effects of Classic LMA insertion and
Endotracheal intubation on heart rate,systolic and diastolic blood pressure and mean arterial
blood pressure during elective surgeries under general anaesthesiain paralyzed patients.
Material and Methods: Eighty patients of American Society of Anaesthesiology Physical
Status I
or II undergoing general anaesthesia for General Surgery and ENT surgery procedures were
randomly allocated in twogroups of 40 patients each. Group E had laryngoscopy and
endotracheal intubation done for their airway managementand Group I underwent insertion of
classic LMA . Both the groups were compared for haemodynamic parameters atinduction of
anaesthesia, then immediately after insertion or intubation, and subsequently at 1 minute, 3
minutes and 5minutes after introduction of Classic LMA or Endotracheal tube.
Observations and Results: The increase in heart rate with Classic LMAinsertion was
significantly less than endotracheal intubation till 3 minutes (p<0.0001). The increase in systolic bloodpressure on comparison between the two groups immediately after insertion of device, 1
min, 3 min and 5 min afterinsertion of respective devices, was less with Classic LMA (p <0.05).
The diastolic blood pressure increased more in Group E ascompared to Group I (p<0.05) and the
rise in the mean arterial blood pressure was also lower in Group I.
Conclusion:Both Endotracheal intubation and Classic LMA insertion produced increase in heart
rate, systolic blood pressure, diastolic bloodpressure and mean arterial blood pressure, however
the increase was less with insertion of Classic LMA. Hence, Classic LMA insertionhas better
haemodynamic stability compared to laryngoscopy and endotracheal intubation.