A comparative study of haemodynamic response during LMA supreme insertion versus endotracheal intubation in paralysed patients during general anaesthesia

Abstract

Introduction: LMA Supreme is a device which has recently been gaining popularly as an aid to airway management. During ETT intubation induces reflex sympathetic adrenal stimulation which is associated with raised levels of plasma catecholamines. This raised catecholamines induce hypertension and tachycardia. These effects should be avoided in patients with hypertension, ischemic heart disease, stenotic valvular heart disease, and raised intracranial tension, LMA Supreme can be used to over come the sympathetic response.Materials and Methods: 80 patients of either sex, aged 18 to 50 yrs posted for elective surgeries. Randomized to 2 groups N=40 each. We recorded HR, SBP, DBP, MAP, ETCO2, SPO2 at 0, 1, 5, 10 min and post extubation after LMA Supreme insertion, ET tube intubation and ease of insertion, no of attempts and post operative complications.Results: LMA Supreme airway is a safe and effective mean of maintaining airway. Ease and the simplicity makes the device well tolerated and the pressure response is less than endotracheal intubation. In our study we have observed the ETT intubation had increased haemodynamic responses when compared with LMA-S insertion.Conclusion: LMA Supreme can be suitable alternative to ETT intubation in elective adult surgeries. LMA-S with its unique design will help to expand Anaesthesiologist efficiency in the management of patients.