Comparison of Hemodynamic Alteration between Laryngeal Mask Airway and Endotracheal Tube in Intermediate Duration (1 to 2hours) Operations

Résumé

Introduction: Laryngoscopy and tracheal intubation can cause serious cardiovascular responses in patients such as hypertension, tachycardia, and arrhythmias However, the laryngeal mask airway gained widespread popularity in use as an alternative to the endotracheal tube in short-duration operations.This study aimed to analyze thecomparison of hemodynamic alteration between laryngeal mask airway (LMA)&endotracheal tube (ETT) in intermediate duration (1 to 2 hours) operations. Methods: This cross-sectional study was conducted at the Department of Anesthesiology, Combined Military Hospital (CMH), Dhaka, Bangladesh, from September 2014 to February 2015. A total of 100 subjects were selected as per inclusion criteria. Respondents were divided into 2 groups, consisting of 50 in each group; group A (airway was maintained with laryngeal mask airway) and group B (airway was maintained with endotracheal tube).Statistical analysis of the results was obtained by using Statistical Packages for Social Sciences (SPSS-25) software. Result:In this study, the mean age of group A respondents was 25.93±SD years, and the mean age of group B respondents was 26.87±SD years. The mean weight of group A was 47.81±6.98 Kg, and the mean weight

of group B was 48.99±SD Kg.  The mean baseline heart rate of group A respondents was

78.54±SD bpm, 79.92±SD bpm at 2 min, 78.96±SD bpm at 5 min, and 69.48±SD bpm at removal. The mean baseline heart rate of group B respondents was 71.20±SD bpm, 104.00±SD bpm at 2min, 108.58±SD bpm at 5min, 91.64±SD bpm at 10min, and 109.52±SD bpm at removal. Mean systolic blood pressure at baseline of group A respondents was 103.10±SD mmHg, 105.10±SD mmHg at 2min, 101.89±SD mmHg at 5min, 104.46±Sd at 10min, and 105.08±SD at removal. The mean SBP of group B subjects at baseline was 101.58±SD mmHg, 130.92±SD mmHg at 2min, 130.92±SD mmHg at 5min, 126.40±SD mmHg at 10min, 138.50±SD at removal.  The mean DBP of group A subjects was 65.94±SD mmHg, 65.62±Sd mmHg at 2min, 69.52±SD mmHg at 5min, 65.86±SD mmHg at 10min, 66.86±SD mmHg at removal. The mean DBP of group B study respondents was 67.20±SD mmHg, 88.40±SD mmHg at 2min, 90.34±SD mmHg at 5min, 84.26±SD mmHg at 10min, and 92.06±SD mmHg at removal. In terms of SpO2, the p-value was not significant at baseline and was significant at 2 min, 5min, 10min, and at the time of removal. Conclusion:This study concluded that LMA insertion causes fewer changes in hemodynamic parameters when compared with that ETT intubation. Findings suggested that LMA can be a safe and beneficial alternative to ETT for ASA Grade-I and II patients undergoing intermediate-duration surgical procedures.