Title: Hemodynamic Response Following Endotracheal Intubation Using Intubating Laryngeal Mask Airway in Comparison with Conventional Macintosh Laryngoscope; A Prospective Randomised Controlled Trial
Authors: Dr Priyanka Dhankhar, Dr Chandini Robinson Daniel
DOI: https://dx.doi.org/10.18535/jmscr/v9i8.18
Abstract
Background: Aims to test the possible advantages offered by use of ILMA guided endotracheal intubation in patients with normal airways in association with direct laryngoscopy and compare the ILMA and DL taking into account the ease of intubation and to see if ILMA has any advantages over DL with regards to patient hemodynamic response to intubation
Methods: Prospective, randomised single blind study. Based on statistically derived formula, patients were randomly allotted to one of two groups. Group DL (patients with direct laryngoscopy), and Group ILMA (patients with ILMA). Randomisation was done via computer generated randomisation table and concealment of allotment was done using sealed envelope technique to be opened prior to induction.
Results: A significant rise of heart rate was noted in DL group as compared to ILMA in the 5 minute and 10 minute interval post intubation. Mean Arterial blood pressure was increased from baseline immediately post intubation in both groups. The rise was significantly higher in DL than ILMA group. The rise in MBP was persistently higher in DL group as compared to ILMA group.
Conclusion: In this study it was found that the ILMA guided endotracheal intubation produces a less marked sympathetic response. This might not be of importance in the healthy normotensive patients, but it could be of importance in the patient with pre existing cardiac or cerebral pathology or hypertension. Therefore, where appropriate, the use of the ILMA would be recommended in such patient to avoid the marked response produced by the ETT.
Keywords: ILMA, ETT, ASA.
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